title: Current status and future perspectives on alcohol septal ablation for hypertrophic obstructive cardiomyopathy.
abstract: Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiac disease. Patients may present with a wide variety of symptoms, ranging from relatively asymptomatic to heart failure, recurrent syncope, angina, or sudden death. Once diagnosed, a thorough clinical, anatomic and physiologic assessment should be undertaken. Treatment options include both pharmacologic and invasive therapies, with a goal to reduce symptoms and possibly extend longevity. Traditionally, the "gold standard" for treating severe obstructive HCM has been ventricular septal myotomy-myomectomy. Since its introduction in 1994, alcohol septal ablation (ASA) has emerged as an acceptable alternative in patients who meet strict anatomic criteria, and has been supported in recent guidelines. We review the indications, technique, competency requirements, alternatives, outcomes, complications, and future directions of ASA.
authors.affiliation: Department of Medicine, Division of Cardiovascular Diseases, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: Rami N
authors.initials: RN
authors.lastname: Khouzam
authors.forename: Srihari S
authors.initials: SS
authors.lastname: Naidu
mesh_terms: D055011:Ablation Techniques / Q000379:methods; D002312:Cardiomyopathy, Hypertrophic / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D002983:Clinical Competence; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D006327:Heart Block / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control*; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D008297:Male; D018579:Patient Selection; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome; D054088:Ventricular Septum / Q000503:physiopathology / Q000601:surgery*
chemical_list: D000431:Ethanol