[Safety and efficacy comparison of myocardial contrast enhancement-guided and angio-pressure-guided transcoronary ablation of septal hypertrophy for patients with hypertrophic obstructive cardiomyopathy].
OBJECTIVE
To compare the safety and efficacy of myocardial contrast enhancement (MCE)-guided and angio-pressure (AP)-guided transcoronary ablation of septal hypertrophy (TASH) for patients with hypertrophic obstructive cardiomyopathy (HOCM).


METHODS
TASH was performed under MCE-guide (n = 47, group I) or AP-guide (n = 25, group II) for drug-refractory patients with HOCM. Myocardial perfusion imaging (MPI) data as well as other clinical data were compared.


RESULTS
TASH both under MCE-guide or AP-guide resulted in similar and significant reduction of left ventricular outflow tract gradient (PG) and associated with significant symptom improvement (all P < 0.001). Dosage of ethanol use, peak-level of CK-MB and ablated myocardial area and incidence of arrhythmia were also similar between the two groups.Similar left ventricular/atrial dimension changes post TASH were observed in the 2 groups during follow-up. However, the first selected septal vessels were changed under MCE in 6 patients.


CONCLUSIONS
Our data demonstrated that the MCE-guided TASH was not superior to AP-guided TASH in safety and efficacy. However, MCE-guided TASH can avoid the misplace of ethanol to avoid innocent myocardial ablation.
Gao
Yue-chun
YC
Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China.
Li
Yu
Y
Wu
Xue-si
XS
Jia
Chang-qi
CQ
Jiang
Teng-yong
TY
D000328:Adult; D006328:Cardiac Catheterization / Q000379:methods*; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D014463:Ultrasonography