title: Alcohol septal ablation in obstructive hypertrophic cardiomyopathy: four years of experience at a reference center.
abstract: BACKGROUND
  We describe our center's initial experience with alcohol septal ablation (ASA) for the treatment of obstructive hypertrophic cardiomyopathy. The procedure, its indications, results and clinical outcomes will be addressed, as will its current position compared to surgical myectomy.
  
  
  OBJECTIVE
  To assess the results of ASA in all patients treated in the first four years of activity at our center.
  
  
  METHODS
  We retrospectively studied all consecutive and unselected patients treated by ASA between January 2009 and February 2013.
  
  
  RESULTS
  In the first four years of experience 40 patients were treated in our center. In three patients (7.5%) the intervention was repeated. Procedural success was 84%. Minor complications occurred in 7.5%. Two patients received a permanent pacemaker for atrioventricular block (6% of those without previous pacemaker). The major complication rate was 5%. There were no in-hospital deaths; during clinical follow-up (22 ± 14 months) cardiovascular mortality was 2.5% and overall mortality was 5%.
  
  
  CONCLUSIONS
  The results presented reflect the initial experience of our center with ASA. The success rate was high and in line with published results, but with room to improve with better patient selection. ASA was shown to be safe, with a low complication rate and no procedure-related mortality. Our experience confirms ASA as a percutaneous alternative to myectomy for the treatment of symptomatic patients with obstructive hypertrophic cardiomyopathy refractory to medical treatment.
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal. Electronic address: antoniojosefiarresga@spc.pt.
authors.forename: António
authors.initials: A
authors.lastname: Fiarresga
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal.
authors.forename: Duarte
authors.initials: D
authors.lastname: Cacela
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Galrinho
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal.
authors.forename: Ruben
authors.initials: R
authors.lastname: Ramos
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal.
authors.forename: Lídia
authors.initials: L
authors.lastname: de Sousa
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Bernardes
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal.
authors.forename: Lino
authors.initials: L
authors.lastname: Patrício
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Cruz Ferreira
mesh_terms: D055011:Ablation Techniques; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000628:therapy*; D000431:Ethanol; D005260:Female; D006346:Heart Septum; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000431:Ethanol
keywords: Ablação septal alcoólica; Alcohol septal ablation; Cardiomiopatia hipertrófica obstrutiva; Obstructive hypertrophic cardiomyopathy; Percutaneous treatment; Tratamento percutâneo