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Alcohol septal ablation in patients with severe septal hypertrophy

Published on Aug 30, 2019in Heart5.082
· DOI :10.1136/heartjnl-2019-315422
Josef Veselka22
Estimated H-index: 22
(Charles University in Prague),
Morten Søndergaard Jensen12
Estimated H-index: 12
(UCPH: University of Copenhagen)
+ 11 AuthorsLothar Faber31
Estimated H-index: 31
(RUB: Ruhr University Bochum)
Abstract
Objective The current guidelines suggest alcohol septal ablation (ASA) is less effective in hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular hypertrophy, despite acknowledging that systematic data are lacking. Therefore, we analysed patients in the Euro-ASA registry to test this statement. Methods We compared the short-term and long-term outcomes of patients with basal interventricular septum (IVS) thickness Results A total of 1519 patients (57±14 years, 49% women) with symptomatic HOCM were treated, including 67 (4.4%) patients with IVS thickness ≥30 mm. The occurrence of short-term major adverse events were similar in both groups. The mean follow-up was 5.4±4.3 years and 5.1±4.1 years, and the all-cause mortality rate was 2.57 and 2.94 deaths per 100 person-years of follow-up in the IVS Conclusions The short-term results and the long-term relief of dyspnoea, residual left ventricular outflow obstruction and occurrence of repeated septal reduction procedures in patients with basal IVS ≥30 mm is similar to those with IVS
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References30
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#1Francesco PellicciaH-Index: 23
#2Giampaolo NiccoliH-Index: 39
Last. Paolo CalabròH-Index: 30
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#1Morten Kvistholm Jensen (Aarhus University Hospital)H-Index: 9
#2Lothar Faber (RUB: Ruhr University Bochum)H-Index: 31
Last. Josef Veselka (Charles University in Prague)H-Index: 22
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Abstract Background Alcohol-induced infarction for treatment of symptomatic hypertrophic obstructive cardiomyopathy (HOCM) was discussed as a risk factor for increased cardiac mortality during follow-up. Objectives This study sought to report on long-term survival after echo-guided alcohol septal ablation (percutaneous transluminal septal myocardial ablation [PTSMA]) in symptomatic patients with HOCM. Methods Between May 2000 and June 2017, PTSMA with alcohol injection was performed in 952 patie...
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#1Max LiebregtsH-Index: 9
#2Lothar Faber (RUB: Ruhr University Bochum)H-Index: 31
Last. Josef Veselka (Charles University in Prague)H-Index: 22
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#1Angelos G. Rigopoulos (MLU: Martin Luther University of Halle-Wittenberg)H-Index: 15
#2S. Sakellaropoulos (MLU: Martin Luther University of Halle-Wittenberg)H-Index: 2
Last. Michel Noutsias (MLU: Martin Luther University of Halle-Wittenberg)H-Index: 32
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Transcatheter alcohol septal ablation (ASA) treatment of symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM) is based on the existence and degree of intraventricular obstruction. Patients with significant gradient and symptoms who do not respond to optimal medical therapy are eligible to gradient reduction through a surgical (septal myectomy) or a transcatheter (alcohol septal ablation) septal reduction. The latter encompasses occlusion of a septal branch perfusing the hyper...
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#1Amelie Burghardt (RUB: Ruhr University Bochum)H-Index: 1
#2Frank van Buuren (RUB: Ruhr University Bochum)H-Index: 12
Last. Lothar Faber (RUB: Ruhr University Bochum)H-Index: 31
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Background and study objective Different studies have shown a good long-term survival with improvement of symptoms and hemodynamics after percutaneous septal ablation (PTSMA), similar to myectomy considered to be the therapeutic “gold standard” for symptomatic hypertrophic obstructive cardiomyopathy (HOCM). Furthermore, desobliteration of left ventricular (LV) outflow may modify features of the disease considered to be risk-relevant, such as magnitude of LV hypertrophy, outflow gradient, and lef...
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#1Josef Veselka (Charles University in Prague)H-Index: 22
#2Lothar Faber (RUB: Ruhr University Bochum)H-Index: 31
Last. Max LiebregtsH-Index: 9
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Abstract Background The current American College of Cardiology Foundation/American Heart Association guidelines on hypertrophic cardiomyopathy state that institutional experience is a key determinant of successful outcomes and lower complication rates of alcohol septal ablation (ASA). The aim of this study was to evaluate the safety and efficacy of ASA according to institutional experience with the procedure. Methods We retrospectively evaluated 1310 patients with symptomatic obstructive hypertr...
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