title: Intracardiac echocardiography guidance during percutaneous transluminal septal myocardial ablation in patients with obstructive hypertrophic cardiomyopathy.
abstract: 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.
authors.affiliation: Bellaria Hospital, Cardiology Department, Bologna, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Pedone
authors.forename: Maniyal
authors.initials: M
authors.lastname: Vijayakumar
authors.forename: Jourgen M L
authors.initials: JM
authors.lastname: Ligthart
authors.forename: Marco
authors.initials: M
authors.lastname: Valgimigli
authors.forename: Elena
authors.initials: E
authors.lastname: Biagini
authors.forename: Nico
authors.initials: N
authors.lastname: De Jong
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Folkert J
authors.initials: FJ
authors.lastname: Ten Cate
mesh_terms: 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