Inferior infarction following alcohol septal ablation: a consequence of "collateral damage"?
Alcohol septal ablation is fast becoming the most common method to reduce left ventricular outflow tract gradient in patients with symptomatic hypertrophic obstructive cardiomyopathy. Myocardial contrast echocardiography (MCE) is routinely used as an adjunct to avoid the spread of alcohol to non-target areas of myocardium. We report two cases where despite the careful use of MCE, remote inferior wall myocardial infarctions occurred. The likely mechanism and possible preventive measures are discussed.
Chowdhary
Saqib
S
Department of Cardiology, Wythenshawe Hospital, South Manchester University Hospitals, Manchester, United Kingdom. saqib.c@btinternet.com
Galiwango
Paul
P
Woo
Anna
A
Schwartz
Leonard
L
D000368:Aged; D006328:Cardiac Catheterization; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000188:drug therapy*; D017023:Coronary Angiography; D004452:Echocardiography; D004562:Electrocardiography; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000379:methods; D000431:Ethanol / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology*; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging / Q000628:therapy
D000431:Ethanol