Remote infarction following percutaneous transluminal septal myocardial ablation: a report of two cases

Chikkabasavaiah, Nagamani Alur; Puttegowda, Beeresha; Panneerselvam, Arunkumar; Ananthakrishna, Rajiv; Kapanigowda, Aravinda Prasad; Basavappa, Ramesh

doi:10.1007/s12928-010-0038-8

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…Those include remote myocardial necrosis in case of ethanol passage through collaterals or spillage into the LAD. Such complications have been previously reported, even in patients with no obvious collaterals originating from septal arteries (10)(11)(12)(13) and despite the use of preventive measures such as selective septal angiogram and MCE. Therefore, patients presenting patent collaterals originating from the septal perforators to other territories should usually be considered unsuitable for ASA.…”

Section: Discussionmentioning

confidence: 85%

Alcohol septal ablation for hypertrophic obstructive cardiomyopathy in a patient with a chronic total occlusion of the right coronary artery: “beware of collateral damage”

Hemptinne

Picard

L’Allier

2017

Cardiovasc. Diagn. Ther.

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Alcohol septal ablation (ASA) is an effective semi-invasive alternative to surgical myectomy in selected patients for the management of severely symptomatic and drug-refractory hypertrophic obstructive cardiomyopathy (HOCM). One contraindication of this procedure is the presence of collateral flow originating from the target septal perforator to a remote myocardial territory. In such circumstances, ethanol injection could cause remote non-target myocardial necrosis in the collateralized territory. Percutaneous revascularization of the collateralized vessel prior to ASA might cope with this contraindication by restoring normal antegrade flow in the occluded artery. We report a case that illustrates the feasibility and efficacy of such strategy.

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Section: Discussionmentioning

confidence: 85%

Alcohol septal ablation for hypertrophic obstructive cardiomyopathy in a patient with a chronic total occlusion of the right coronary artery: “beware of collateral damage”

Hemptinne

Picard

L’Allier

2017

Cardiovasc. Diagn. Ther.

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“…The most significant complications include high-degree conduction block needing PPM, acute myocardial infarction, cardiac shock, cardiac death, puncture site complications. 6 - 8 Unfortunately, only predictors for long follow-up outcome have ever been analyzed. 7 , 9 The analysis of risk factors for predicting related complications have not been reported to date.…”

Section: Introductionmentioning

confidence: 99%

Retrospective Analysis of Risk Factors for Related Complications of Chemical Ablation on Hypertrophic Obstructive Cardiomyopathy

Li¹,

Yun-qi²

2019

Arquivos Brasileiros De Cardiologia

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Background The analysis of risk factors for predicting related complications has not been reported to date. Objective This study aims to investigate the risk factors of related complications of percutaneous transluminal septal myocardial ablation (PTSMA) for hypertrophic obstructive cardiomyopathy (HOCM) retrospectively. Method Clinical data, and one-year follow-up results of patients with HOCM, who underwent PTSMA between January 2000 and July 2013 in the Department of Cardiology, Liaoning Province People’s Hospital, Liaoning Province, China, were retrospectively analyzed to determine risk factors for operative complications with multiple logistic regression analysis. All p values are two-sided, with values of p < 0.05 being considered statistically significant. Results Among 319 patients with HOCM, PTSMA was performed in 224 patients (120 males and 104 females, mean age was 48.20 ± 14.34 years old). The incidence of PTSMA procedure-related complications was 36.23% (66/224), which included three cardiac deaths, two cardiac shocks, one ST-segment elevated myocardial infarction, two ventricular fibrillations, 20 third-degree atrioventricular (AV) blocks (four patients were implanted with a permanent pacemaker (PPM)), 32 complete right bundle branch blocks, two complete left bundle branch blocks, and four puncture-related complications. After multivariate logistic regression analysis, it was found that age, gender, coronary artery diseases, diabetes, heart rate, cardiac function on admission, the number of septal ablations, and the volume of alcohol were not independent risk factors correlated to the whole complications, except for hypertension (OR: 4.856; 95% CI: 1.732-13.609). Early experience appears to be associated with the occurrence of complications. Conclusion Hypertension was an independent risk factor for PTSMA procedure-related complications. It might be much safer and more efficient if PTSMA procedures are restricted to experienced centers, according to the analysis results for the learning curve.

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A case of delayed complete atrioventricular block and cardiac arrest after percutaneous coronary intervention of left anterior descending coronary artery

Hamatani

Unoki

Ogawa

et al. 2013

Cardiovasc Interv and Ther

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Delayed complete atrioventricular (AV) block due to jailed septal branch during percutaneous coronary intervention (PCI) of left anterior descending artery is a rare complication. Here, we present a case of an elderly male who developed episodes of complete AV block and cardiac arrest 2 days after transient occlusion of the septal branch during PCI, and received permanent pacemaker implantation. This case had shown first-degree AV block plus right bundle branch block before PCI, and the presence of these preexisting conduction abnormalities may have been the underlying mechanism by which the transient occlusion of jailed septal branch cause complete AV block.

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Remote infarction following percutaneous transluminal septal myocardial ablation: a report of two cases

Cited by 3 publications

References 9 publications

Alcohol septal ablation for hypertrophic obstructive cardiomyopathy in a patient with a chronic total occlusion of the right coronary artery: “beware of collateral damage”

Alcohol septal ablation for hypertrophic obstructive cardiomyopathy in a patient with a chronic total occlusion of the right coronary artery: “beware of collateral damage”

Retrospective Analysis of Risk Factors for Related Complications of Chemical Ablation on Hypertrophic Obstructive Cardiomyopathy

A case of delayed complete atrioventricular block and cardiac arrest after percutaneous coronary intervention of left anterior descending coronary artery

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