Alcohol septal ablation: A useful tool in our arsenal against hypertrophic obstructive cardiomyopathy

Abstract

Objective Affecting 1 in 500 individuals; hypertrophic cardiomyopathy is an autosomal dominant cardiovascular disorder which is prevalent throughout the world. Surgical myectomy (SM) and alcohol septal ablation (ASA) are two methods currently used for the management of drug refractory hypertrophic obstructive cardiomyopathy (HOCM). ASA may prove to be a useful, less invasive treatment in patients with HOCM Methods Electronic literature search was conducted to identify articles that discussed methods to treat drug refractory HOCM. No limits were placed on timing of the publication or the type of article. Keywords and MeSH terms were used and the results were summarized in the relevant section. Results Current evidence suggests that alcohol septal ablation is a safe and effective procedure in treating patients with HOCM with similar short‐ and long‐term outcomes when compared with SM. Conclusion ASA has been shown to be a safe and reliable procedure; imaging techniques and dedicated multi‐disciplinary teams can be used to select patients with HOCM. Though SM is recommended as gold standard treatment for drug refractory HOCM, ASA may play an increasing role in the near future due an ageing population; both ASA and SM can have a beneficial role in treating those who are affected by HOCM when the appropriate group of patients are selected for each intervention.

Alcohol Septal Ablation: An Option on the Rise in Hypertrophic Obstructive Cardiomyopathy

“…The echo-bright contrast should enhance the proximal hypertrophied septum at the point of maximal systolic anterior motion of the anterior mitral valve leaflet with associated septal contact. Also, this tool has played an essential role in ASA, minimizing periprocedural complications [ 1 , 30 ]. Due to the anatomical variations of the territory perfused by the first septal, the area supplied by this vessel may include a variable quantity of myocardial tissue, which could involve apart the hypertrophied basal septum, also the right ventricular septum, free wall and even the apex of the LV.…”

Alcohol Septal Ablation or Septal Myectomy? An Updated Systematic Review and Meta-Analysis of Septal Reduction Therapy for Hypertrophic Obstructive Cardiomyopathy

“…Surgical treatment with septal myectomy (SM), considered the “gold standard” for the treatment of severe hypertrophic obstructive cardiomyopathy, can reduce the left ventricular outflow tract pressure gradient, release the degree of outflow tract obstruction, and improve the cardiac function and prognosis ( 4 ). With the continuous development of cardiac interventional technology and the emergence of new therapeutic instruments, alcohol septal ablation (ASA) has accumulated considerable supporting clinical evidence because of it causes less trauma with a rapid recovery, especially for elderly patients or patients with a variety of chronic diseases ( 5 ).…”