Intracardiac echocardiography guidance during percutaneous transluminal septal myocardial ablation in patients with obstructive hypertrophic cardiomyopathy.
BACKGROUND
Percutaneous transluminal septal myocardial ablation (PTSMA) recently emerged as an alternative to myectomy for hypertrophic obstructive cardiomyopathy (HOCM) patients with drug-refractory symptoms. The target septal branch selection is a main point to achieve the therapeutic result.


RESULTS
We report about PTSMA performed using intracardiac echocardiography (ICE) to guide the procedure in 9 symptomatic HOCM patients. The target septal branch was chosen on the basis of the risk-area visualized using ICE after injection of a contrast agent. During alcohol administration a backscattered signal enhancement of the infarcted area was detected. The procedures were uncomplicated and effective to reduce the gradient from 78.9+/-20.4 mmHg to 7.8+/-7.9 mmHg (p<0.0001).


CONCLUSIONS
In this initial experience ICE monitoring during PTSMA was safe and provided high quality and continuous imaging of the treated segment of the septum during the whole procedure.
Pedone
Chiara
C
Bellaria Hospital, Cardiology Department, Bologna, Italy.
Vijayakumar
Maniyal
M
Ligthart
Jourgen M L
JM
Valgimigli
Marco
M
Biagini
Elena
E
De Jong
Nico
N
Serruys
Patrick W
PW
Ten Cate
Folkert J
FJ
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D002304:Cardiac Pacing, Artificial; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000628:therapy; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D004452:Echocardiography / Q000379:methods / Q000592:standards*; D005260:Female; D006327:Heart Block / Q000209:etiology / Q000628:therapy; D006346:Heart Septum / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D015203:Reproducibility of Results; D016896:Treatment Outcome