Alcohol septal ablation for symptomatic hypertrophic obstructive cardiomyopathy in patients with prior coronary revascularization.
Alcohol septal ablation has become an acceptable alternative to surgical myectomy in patients with hypertrophic obstructive cardiomyopathy who remain significantly symptomatic after optimized medical management and meet strict anatomic criteria. Given the prevalence of coronary artery disease and the variable phenotypic penetrance and age at first diagnosis of hypertrophic cardiomyopathy (HCM), patients may undergo coronary revascularization before a firm diagnosis of HCM is made. Patients with prior revascularization in the form of percutaneous coronary intervention or coronary artery bypass grafting pose unique challenges when contemplating and performing alcohol septal ablation. We present two cases of alcohol septal ablation after prior coronary revascularization, and discuss relevant concerns regarding patient selection, procedural technique and consequent durability of clinical outcome.
Department of Medicine, Division of Cardiology, Winthrop University Hospital, Mineola, New York, USA.
Rami N
RN
Khouzam
Srihari S
SS
Naidu
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000628:therapy; D004452:Echocardiography; D000431:Ethanol; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D000431:Ethanol