Skip to main content

Alcohol Septal Ablation: Technique and Outcome

  • Chapter
  • First Online:
Hypertrophic Cardiomyopathy

Abstract

Dynamic left ventricular outflow tract obstruction is common in patients with hypertrophic cardiomyopathy, and can be associated with debilitating symptoms of heart failure. For those patients with drug-refractory symptoms, alcohol septal ablation is an effective therapy. The outcomes of alcohol septal ablation can approach the gold standard of surgical myectomy when performed in selected patients and in centers that are dedicated to the comprehensive, longitudinal care of patients with HCM.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Maron BJ. Hypertrophic cardiomyopathy: a systematic review. JAMA. 2002;287:1308–20.

    PubMed  Google Scholar 

  2. Maron MS, Olivotto I, Zenovich AG, et al. Hypertrophic cardiomyopathy is predominantly a disease of left ventricular outflow tract obstruction. Circulation. 2006;114:2232–9.

    Article  PubMed  Google Scholar 

  3. Gersh BJ, Maron BJ, Bonow RO, et al. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Developed in collaboration with the American Association for Thoracic Surgery, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2011;58:e212–60.

    Article  CAS  PubMed  Google Scholar 

  4. Sigwart U. Non-surgical myocardial reduction for hypertrophic obstructive cardiomyopathy. Lancet. 1995;346:211–4.

    Article  CAS  PubMed  Google Scholar 

  5. Ommen SR, Maron BJ, Olivotto I, et al. Long-term effects of surgical myectomy on survival in patients with obstructive hypertrophic cardiomyopathy. J Am Coll Cardiol. 2005;46:470–6.

    Article  PubMed  Google Scholar 

  6. Sorajja P, Ommen SR, Holmes Jr DR, et al. Survival after alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Circulation. 2012;126:2374–80.

    Article  PubMed  Google Scholar 

  7. Valeti US, Nishimura RA, Holmes DR, et al. Comparison of surgical septal myectomy and alcohol septal ablation with cardiac magnetic resonance imaging in patients with hypertrophic obstructive cardiomyopathy. J Am Coll Cardiol. 2007;49:350–7.

    Article  PubMed  Google Scholar 

  8. Talreja DR, Nishimura RA, Edwards WD, et al. Alcohol septal ablation versus surgical septal myectomy: comparison of effects on atrioventricular conduction tissue. J Am Coll Cardiol. 2004;44:2329–32.

    Article  PubMed  Google Scholar 

  9. Sorajja P, Valeti U, Nishimura RA, et al. Outcome of alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Circulation. 2008;118:131–9.

    Article  PubMed  Google Scholar 

  10. Sorajja P, Binder J, Nishimura RA, et al. Predictors of an optimal clinical outcome with alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Catheter Cardiovasc Interv. 2013;81:E58–67.

    Article  PubMed  Google Scholar 

  11. Van Dockum WG, Beek AM, ten Cate FJ, et al. Early onset and progression of left ventricular remodeling after alcohol septal ablation in hypertrophic obstructive cardiomyopathy. Circulation. 2005;111:2503–8.

    Article  PubMed  Google Scholar 

  12. Singh M, Edwards WD, Holmes Jr DR, Tajik AJ, Nishimura RA. Anatomy of the first septal perforating artery: a study with implications for ablation therapy for hypertrophic cardiomyopathy. Mayo Clin Proc. 2001;76:799–802.

    Article  CAS  PubMed  Google Scholar 

  13. Firoozi S, Elliott PM, Sharma S, Murday A, et al. Septal myotomy-myectomy and transcoronary septal alcohol ablation in hypertrophic obstructive cardiomyopathy: a comparison of clinical, hemodynamic and exercise outcomes. Eur Heart J. 2002;23:1617–24.

    Article  CAS  PubMed  Google Scholar 

  14. Nagueh S, Ommen SR, Lakkis NM, et al. Comparison of ethanol septal reduction therapy with surgical myectomy for the treatment of hypertrophic obstructive cardiomyopathy. J Am Coll Cardiol. 2001;38:1701–6.

    Article  CAS  PubMed  Google Scholar 

  15. Qin JX, Shiota T, Lever HM, et al. Outcome of patients with hypertrophic obstructive cardiomyopathy after percutaneous transluminal septal myocardial ablation and septal myectomy surgery. J Am Coll Cardiol. 2001;38:1994–2000.

    Article  CAS  PubMed  Google Scholar 

  16. Ralph-Edwards A, Woo A, McCrindle BW, et al. Hypertrophic obstructive cardiomyopathy: comparison of outcomes after myectomy or alcohol ablation adjusted by propensity score. J Thorac Cardiovasc Surg. 2005;129:351–8.

    Article  PubMed  Google Scholar 

  17. Jiang TY, Wu XS, Lu Q, et al. Transcoronary ablation of septal hypertrophy compared with surgery in the treatment of hypertrophic obstructive cardiomyopathy. Chin Med J. 2004;117:296–8.

    PubMed  Google Scholar 

  18. Vural AH, Tiryakioglu O, Turk T, et al. Treatment modalities in hypertrophic obstructive cardiomyopathy: surgical myectomy versus percutaneous septal ablation. Heart Surg Forum. 2007;10:493–7.

    Article  PubMed  Google Scholar 

  19. Fernandes VL, Nielsen C, Nagueh SF, et al. Follow-up of alcohol septal ablation for symptomatic hypertrophic obstructive cardiomyopathy: the Baylor and Medical University of South Carolina experience 1996 to 2007. JACC Cardiovasc Interv. 2008;1:561–70.

    Article  PubMed  Google Scholar 

  20. Kwon DH, Kapadia SR, Tuzcu EM, et al. Long-term outcomes in high-risk symptomatic patients with hypertrophic cardiomyopathy undergoing alcohol septal ablation. JACC Cardiovasc Interv. 2008;1:432–8.

    Article  PubMed  Google Scholar 

  21. Ten Cate FJ, Solimon OI, Michels M, et al. Long-term outcome of alcohol septal ablation in patients with obstructive hypertrophic cardiomyopathy: a word of caution. Circ Heart Fail. 2010;3:362–9.

    Article  PubMed  Google Scholar 

  22. Faber L, Seggewiss H, Gleichman U. Percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy. Results with respect to intraprocedural myocardial contrast echocardiography. Circulation. 1998;98:2415–21.

    Article  CAS  PubMed  Google Scholar 

  23. Nagueh SF, Groves BM, Schwartz L, et al. Alcohol septal ablation for the treatment of hypertrophic obstructive cardiomyopathy. A multicenter North American registry. J Am Coll Cardiol. 2011;58:2322–8.

    Article  PubMed  Google Scholar 

  24. Agarwal S, Tuzcu EM, Desai MY, et al. Updated meta-analysis of septal alcohol ablation versus myectomy for hypertrophic cardiomyopathy. J Am Coll Cardiol. 2010;55:823–34.

    Article  PubMed  Google Scholar 

  25. Alam M, Doakinsih H, Lakkis NM. Hypertrophic obstructive cardiomyopathy- alcohol septal ablation vs. myectomy: a meta-analysis. Eur Heart J. 2009;30:1080–7.

    Article  PubMed  Google Scholar 

  26. Olivotto I, Ommen SR, Maron MS, Cecchi F, Maron BJ. Surgical myectomy versus alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Will there ever be a randomized trial. J Am Coll Cardiol. 2007;50:831–4.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Paul Sorajja MD, FACC, FAHA, FSCAI .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag London

About this chapter

Cite this chapter

Sorajja, P. (2015). Alcohol Septal Ablation: Technique and Outcome. In: Naidu, S. (eds) Hypertrophic Cardiomyopathy. Springer, London. https://doi.org/10.1007/978-1-4471-4956-9_19

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-4956-9_19

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4955-2

  • Online ISBN: 978-1-4471-4956-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics