Effects of varying ethanol dosing in percutaneous septal ablation for obstructive hypertrophic cardiomyopathy on early hemodynamic changes

Veselka, Josef; Duchoňová, Radka; Procházková, Šárka; Páleníc̆ková, Jana; Sorajja, Paul; Tesař, David

doi:10.1016/j.amjcard.2004.10.050

Cited by 52 publications

(50 citation statements)

References 15 publications

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“…As published previously, the time course of changes in the LVOT gradient is biphasic, 16,19,20,22 and the main mechanism of the sustained relief of the LVOT gradient is LV remodeling developing secondary to infarction and fibrosis of the basal septum. 17 As was shown in the previous studies, this remodeling process may proceed for several months and usually is completed after 1 year.…”

Section: Discussionmentioning

confidence: 70%

“…[16][17][18][19] In brief, the presence or absence of significant epicardial coronary artery disease was documented by coronary angiography. A temporary pacemaker was placed in all patients except those who already had a permanent pacemaker or implantable cardioverter difibrillator.…”

Section: Methodsmentioning

confidence: 99%

“…4 The hemodynamic and clinical benefits of ASA have been clearly demonstrated in many studies to date. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Reduction of the gradient of the left ventricular outflow tract (LVOT) is biphasic and significant during the early post procedural period; 16,20 however, our clinical experience has suggested that the hemodynamic benefit is less distinct in a subgroup of younger patients. Thus, the aim of our retrospective study was to compare the time course of both hemodynamic and morphological changes with regard to the age of the treated patients.…”

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confidence: 99%

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Age-Related Hemodynamic and Morphologic Differences in Patients Undergoing Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy

Veselka

Duchoňová

Páleníc̆ková

et al. 2006

Circ J

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Background Alcohol septal ablation (ASA) decreases the left ventricular (LV) outflow gradient and relieves symptoms in patients with highly symptomatic hypertrophic obstructive cardiomyopathy (HOCM). The aim of this study was to evaluate the early course of hemodynamic, morphologic and clinical changes in younger and elderly patients. Methods and Results Forty-four consecutive patients (age, 24-81 years) underwent the ASA procedure for HOCM. Clinical and echocardiographic data were obtained at baseline and periodically up to 12 months after ASA. There was a significant correlation between septum thickness and age at baseline and in the early post procedural period (p=0.004 at baseline, p=0.0033 days postoperative, p=0.0193 weeks pos operative). The dependence of septal thickness on the duration of follow-up (p<0.001) was significantly influenced by age (p=0.026), which retained statistical significance after multivariate adjustment (p=0.031). A decrease in the gradient of the LV outflow was identified in all age-related groups of patients (p<0.001). After multivariate adjustment, there was a significant influence of age (p=0.003) and creatine kinase-MB peak (p=0.016) on the course of outflow gradient reduction. Conclusions ASA is an effective treatment option for patients with HOCM, irrespective of their age. Younger patients are characterized by a thicker basal septum at baseline and a slower hemodynamic improvement within the early post procedural period. (Circ J 2006; 70: 880 -884)

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Section: Discussionmentioning

confidence: 70%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Age-Related Hemodynamic and Morphologic Differences in Patients Undergoing Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy

Veselka

Duchoňová

Páleníc̆ková

et al. 2006

Circ J

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“…The risk of transient or permanent conduction abnormalities after alcohol septal ablation is related to the volume and localization of the myocardium supplied by the occluded artery as well as by the amount of alcohol injected into the septal branch [28][29][30][31][32]. There is a positive correlation between extent of the necrosis caused by ASA and the frequency of conduction abnormalities during and after the procedure [33].…”

Section: Ryc 3 Zapis Jednoczesnego Pomiaru Ciśnień W Lewej Komorze mentioning

confidence: 90%

“…Despite the use of lower amounts of alcohol (1.5-2 ml) and its slower injection into the artery with prolonged 10 min inflation of the balloon occluding the septal branch, which reduced the ASA complications, especially those related to conduction abnormalities, there is still a group of patients qualified for ASA in whom the risk of described complications is higher and may be a contraindication for this procedure [28,[30][31][32]. This group includes patients with atrioventricular conduction abnormalities present before the procedure or with a large septal branch penetrating to the lower parts of the interventricular septum or covering the whole thickness of the myocardium [34].…”

Section: Ryc 3 Zapis Jednoczesnego Pomiaru Ciśnień W Lewej Komorze mentioning

confidence: 99%

Non-surgical septal reduction by coil embolization in patients with hypertrophic obstructive cardiomyopathy. An alternative to alcohol ablation

Dąbrowski¹,

Witkowski²,

Brzozowski³

et al. 2011

pwki

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A b s t r a c tDynamic obstruction of the left ventricular outflow tract is present in 25-30% of patients with Hypertrophic Cardiomyopathy (HCM). The non-surgical method of interventricular septum thickness reduction using coils is a new technique of percutaneous treatment in patients with hypertrophic obstructive cardiomyopathy (HOCM). The presented method could be an interesting alternative for left ventricular outflow tract pressure gradient reduction in patients with HOCM in whom alcohol ablation may be related to a higher risk of complications. We present a description of two patients with HOCM and drug-refractory symptoms, who underwent closure of the septal branch using coils in the Institute of Cardiology.Key words: hypertrophic obstructive cardiomyopathy, coil, embolisation, alcohol ablation S t r e s z c z e n i e W grupie pacjentów z kardiomiopatią przerostową (ang. hypertrophic cardiomyopathy, HCM) u 25-30% występuje dynamiczne zawężanie w drodze odpływu lewej komory (ang. left ventricular outflow tract, LVOT). Nową, opisaną zaledwie kilka lat temu, propozycją przezskórnego leczenia osób z kardiomipatią przerostową zawężającą (ang. hypertrophic obstructive cardiomyopathy, HOCM) jest metodą nieoperacyjnej redukcji grubości przegrody międzykomorowej za pomocą koili naczyniowych. Prezentowana metoda może stanowić interesującą alternatywę redukcji gradientu w LVOT u pacjentów z HOCM, u których ablacja alkoholowa jest obarczona zbyt dużym ryzykiem wystąpienia powikłań. Przedstawiamy opis 2 osób z HOCM, u których wykonano zabieg zamknięcia tęt-nicy przegrodowej za pomocą koili w Instytucie Kardiologii w Warszawie.Słowa kluczowe: kardiomiopatia przerostowa zaważająca, koil, embolizacja, ablacja alkoholowa

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Complications of low‐dose, echo‐guided alcohol septal ablation

Veselka

Zemánek

Tomašov

et al. 2009

Cathet Cardio Intervent

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Effects of varying ethanol dosing in percutaneous septal ablation for obstructive hypertrophic cardiomyopathy on early hemodynamic changes

Cited by 52 publications

References 15 publications

Age-Related Hemodynamic and Morphologic Differences in Patients Undergoing Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy

Age-Related Hemodynamic and Morphologic Differences in Patients Undergoing Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy

Non-surgical septal reduction by coil embolization in patients with hypertrophic obstructive cardiomyopathy. An alternative to alcohol ablation

Complications of low‐dose, echo‐guided alcohol septal ablation

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