Surgical Myectomy After Alcohol Ablation for HOCM

For HOCM patients with persistent symptoms, ablation followed by surgery is reasonable, though pacing may be needed.

Alcohol septal ablation is a relatively new technique for treating patients with dynamic LV outflow tract obstruction caused by hypertrophic obstructive cardiomyopathy (HOCM). Hemodynamic and clinical improvement has been reported in most patients (see Journal Watch Cardiology Aug 19 2005). In this paper, investigators report the outcome of surgical myectomy in patients after failed alcohol ablation.

Surgery was performed in 20 of 375 patients who had previously undergone alcohol ablation. Following alcohol ablation, the mean dynamic gradient at rest decreased from 90 to 30 mm Hg, but 13 patients had a residual gradient ≥25 mm Hg. Nine patients required repeat alcohol ablation. At a mean of 19 months after alcohol ablation, all 20 patients u…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI