[Septal alcoholisation of hypertrophic obstructive cardiomyopathy in childhood].
The authors report a case of septal alcoholisation in a 6 year old child with hypertrophic obstructive cardiomyopathy responsible for congestive cardiac failure despite optimal betablocker therapy. The indication was retained in a context of mucoviscidosis complicated by multiresistant bacterial infection. At catheterisation, the dominant septal artery was identified and an alcoholisation was performed by the classic technique described in adults. The immediate result was satisfactory with regression of the signs of cardiac failure and reduction of 70 mmHg of the maximal instantaneous pressure gradient (from 160 to 90 mmHg). However, 10 months later, the signs of right heart failure reappeared with a partial increase in the maximal instantaneous pressure gradient (100 mmHg) leading to surgical myectomy while the patient's condition had considerably improved from the pulmonary point of view. Septal alcoholisation would appear to be a therapeutic alternative in children especially in cases with a temporary or permanent contraindication to conventional surgery.
Abbey
S
S
Clinique de cardiologie, CHU de Nantes, hôpital Guillaume et René Laennec, Nantes.
Guérin
P
P
Gournay
V
V
Lefevre
M
M
Crochet
D
D
D006328:Cardiac Catheterization / Q000379:methods; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications*; D017115:Catheter Ablation / Q000379:methods*; D002648:Child; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000209:etiology*; D006346:Heart Septum / Q000473:pathology*; D006801:Humans; D012997:Solvents / Q000627:therapeutic use*; D016896:Treatment Outcome
D012997:Solvents; D000431:Ethanol