title: Left ventricular opacification during selective intracoronary injection of echocardiographic contrast in patients with hypertrophic cardiomyopathy.
abstract: Percutaneous alcohol ablation of the interventricular septum via the first septal perforator branch of the left anterior descending artery can successfully treat dynamic left ventricular outflow tract obstruction in patients with hypertrophic cardiomyopathy. Increasingly, echocardiographic contrast agents are used before alcohol injection to identify the perfusion bed of the septal perforator vessels. This study describes the unexpected opacification of the left ventricular cavity in three of five consecutive patients following selective injection of the first septal perforator with Optison. This case study demonstrates that direct communication between the first septal perforator vessel and the left ventricle is common, an observation that may have considerable relevance to the technique of alcohol septal reduction.
authors.affiliation: Department of Cardiological Sciences, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK. pelliott@sghms.ac.uk
authors.forename: P M
authors.initials: PM
authors.lastname: Elliott
authors.forename: S J
authors.initials: SJ
authors.lastname: Brecker
authors.forename: W J
authors.initials: WJ
authors.lastname: McKenna
mesh_terms: D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000628:therapy; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000379:methods; D000431:Ethanol / Q000627:therapeutic use; D005260:Female; D006325:Heart Atria; D006346:Heart Septum; D006801:Humans; D008875:Middle Aged; D012997:Solvents / Q000627:therapeutic use; D016157:Vascular Fistula / Q000000981:diagnostic imaging*
chemical_list: D012997:Solvents; D000431:Ethanol