Early opening of dormant septal collaterals during alcohol septal ablation: a possible hazard of remote necrosis.
Alcohol septal ablation has become a common method to relieve left ventricular outflow track gradient in selected patients with hypertrophic obstructive cardiomyopathy. There is only limited knowledge regarding inadvertent remote (nontarget) myocardial necrosis caused by septal collateral recruitment. Herein we describe a case of unexpected contrast medium leakage through newly opened septal collateral circulation immediately after low-dose ethanol injection suggesting that angiographic inspection of collateral recruitment is necessary in all cases of repeat ethanol injection.
Department of Cardiology, CardioVascular Center, University Hospital Motol, 2nd Medical School, Charles University, Prague, Czech Republic. Electronic address: mildaspacek@gmail.com.
Miloslav
M
Spacek
David
D
Zemanek
Pavol
P
Tomasov
Josef
J
Veselka
D055011:Ablation Techniques / Q000009:adverse effects*; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000601:surgery; D003097:Collateral Circulation; D017023:Coronary Angiography; D000431:Ethanol / Q000009:adverse effects*; D005260:Female; D006346:Heart Septum / Q000473:pathology / Q000601:surgery*; D006801:Humans; D009206:Myocardium / Q000473:pathology*; D009336:Necrosis / Q000209:etiology
D000431:Ethanol