title: Alcohol septal ablation after failed surgical myectomy.
abstract: We describe the case of a successful alcohol septal ablation in a patient with persistent gradient and severe symptoms postsurgical myectomy. The alcohol ablation of the thickened septum abolished the left ventricular outflow gradient and the systolic anterior motion (SAM) of the mitral valve. Although the surgical literature advocates for mitral valve replacement in patients who continue to have SAM with significant outflow obstruction postmyectomy, targeted alcohol septal ablation of the remaining septum appears to be an attractive alternative.
authors.affiliation: Division of Cardiology, Loyola University Medical Center, Maywood, Illinois 60153, USA. Domjoyal@hotmail.com
authors.forename: Dominique
authors.initials: D
authors.lastname: Joyal
authors.forename: Dinesh
authors.initials: D
authors.lastname: Arab
authors.forename: Carol
authors.initials: C
authors.lastname: Chen-Johnston
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Leya
mesh_terms: D006348:Cardiac Surgical Procedures; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D004562:Electrocardiography; D000431:Ethanol / Q000008:administration & dosage*; D006329:Heart Conduction System / Q000503:physiopathology; D006346:Heart Septum / Q000601:surgery; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D012086:Reoperation; D012720:Severity of Illness Index; D017211:Treatment Failure; D016896:Treatment Outcome; D014463:Ultrasonography; D016277:Ventricular Function, Left; D014694:Ventricular Outflow Obstruction / Q000209:etiology* / Q000601:surgery
chemical_list: D000431:Ethanol