Computed tomography angiography planning identifies the target vessel for optimum infarct location and improves clinical outcome in alcohol septal ablation for hypertrophic obstructive cardiomyopathy

Cooper, Robert; Binukrishnan, Sukumaran; Shahzad, Adeel; Hasleton, Jonathan; Sigwart, Ulrich; Stables, Rodney H

doi:10.4244/eij-d-15-00159

Cited by 26 publications

(9 citation statements)

References 14 publications

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“…In hypertrophic cardiomyopathy, the findings of myocardial delayed enhancement and LV wall thickness on cardiac CTA show good correlation with that of CMR imaging . Additionally, coronary CTA may be used to guide alcohol septal ablation procedures and plan for surgical myomectomy in patients with significant LV outflow tract obstruction . It may also identify areas of LV non‐compaction characterized by pronounced trabeculations, focal thinning, and RWMAs ( Figure ) .…”

Section: Cardiomyopathiesmentioning

confidence: 95%

Emerging role of cardiac computed tomography in heart failure

et al. 2019

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Despite medical advancements, the prognosis of patients with heart failure remains poor. While echocardiography and cardiac magnetic resonance imaging remain at the forefront of diagnosing and monitoring patients with heart failure, cardiac computed tomography (CT) has largely been considered to have a limited role. With the advancements in scanner design, technology, and computer processing power, cardiac CT is now emerging as a valuable adjunct to clinicians managing patients with heart failure. In the current manuscript, we review the current applications of cardiac CT to patients with heart failure and also the emerging areas of research where its clinical utility is likely to extend into the realm of treatment, procedural planning, and advanced heart failure therapy implementation.

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Section: Cardiomyopathiesmentioning

confidence: 95%

Emerging role of cardiac computed tomography in heart failure

et al. 2019

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“…38,39 In addition, cardiac CT visualizes the size and course of septal perforators within the myocardium, which is of potential interest in preparation for percutaneous SRT. 40 Of note, standard coronary CT angiograms acquired during mid-diastole will overestimate wall thickness compared to images acquired at end-diastole.…”

Section: A Assessment Of Left Ventricular Hypertrophymentioning

confidence: 99%

Recommendations for Multimodality Cardiovascular Imaging of Patients with Hypertrophic Cardiomyopathy: An Update from the American Society of Echocardiography, in Collaboration with the American Society of Nuclear Cardiology, the Society for Cardiovascular Magnetic Resonance, and the Society of Cardiovascular Computed Tomography

Nagueh

Phelan

Abraham

et al. 2022

Journal of the American Society of Echocardiography

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“…The technique aims to produce a limited infarct in the upper interventricular septum through instillation of alcohol via selective cannulation of one or more of the septal perforator vessels. The procedure was initially associated with a high risk of complications including complete heart block, but refinement of the technique including routine intraprocedural myocardial contrast echocardiography to help limit infarct size and the inclusion of preprocedure CT coronary angiography to confirm an appropriate septal branch of the left anterior descending artery (figure 3), thereby minimising the number of aborted procedures, have improved safety and efficacy 33. Meta-analyses of long-term outcomes after septal reduction therapy showed a slightly higher LVOT gradient following ASA compared with myectomy, but with no significant differences between the two procedures in functional parameters 34.…”

Section: Management Of Left Ventricular Outflow Tract Obstructionmentioning

confidence: 99%

Changing concepts in heart muscle disease: the evolving understanding of hypertrophic cardiomyopathy

Moody

Elliott

2022

Heart

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Sixty years ago, hypertrophic cardiomyopathy (HCM) was considered a rare lethal disease that affected predominantly young adults and for which there were few treatment options. Today, it is recognised to be a relatively common disorder that presents throughout the life course with a heterogeneous clinical phenotype that can be managed effectively in the majority of individuals. A greater awareness of the condition and less reluctance from healthcare practitioners to make the diagnosis, coupled with improvements in cardiac imaging, including greater use of artificial intelligence and improved yields from screening efforts, have all helped facilitate a more precise and timely diagnosis. This enhanced ability to diagnose HCM early is being paired with innovations in treatment, which means that the majority of patients receiving a contemporary diagnosis of HCM can anticipate a normal life expectancy and expect to maintain a good functional status and quality of life. Indeed, with increasing translation of molecular genetics from bench to bedside associated with a growing number of randomised clinical trials of novel therapies aimed at ameliorating or perhaps even preventing the disease, the next chapter in the story for HCM will provide much excitement and more importantly, offer much anticipated reward for our patients.

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Computed tomography angiography planning identifies the target vessel for optimum infarct location and improves clinical outcome in alcohol septal ablation for hypertrophic obstructive cardiomyopathy

Abstract: CT angiography planning improves localisation of infarct and procedural success at the first attempt in ASA when compared to traditional methods. Follow-up to six months suggests a symptomatic, functional and haemodynamic improvement.

Cited by 26 publications

References 14 publications

Emerging role of cardiac computed tomography in heart failure

Emerging role of cardiac computed tomography in heart failure

Changing concepts in heart muscle disease: the evolving understanding of hypertrophic cardiomyopathy

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