Long-Term Outcome of Percutaneous Transluminal Septal Myocardial Ablation in Hypertrophic Obstructive Cardiomyopathy

Jensen, Morten Kvistholm; Almaas, Vibeke Marie; Jacobsson, Linda; Hansen, Peter Riis; Havndrup, Ole; Aakhus, Svend; Svane, Bertil; Hansen, Thomas Fritz; Køber, Lars; Endresen, Knut; Eriksson, Maria; Jørgensen, Erik; Amlie, Jan P.; Gadler, Fredrik; Bundgaard, Henning

doi:10.1161/circinterventions.110.959718

Cited by 93 publications

(65 citation statements)

References 34 publications

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“…And, as survival after myectomy, survival after ASA is also comparable with that of general population [8,9]. These data support the notion that ASA may be another intervention which improves survival of patients with obstructive HCM and severe drug-refractory symptoms.…”

Section: Introductionsupporting

confidence: 75%

“…However, we are still not sure whether this technique extends longevity of its target patients. Results from several studies suggest that ASA can extend longevity of patients with HCM [6][7][8][9][10][11][12]. Here, we extended evidence for this notion by directly comparing the survival of patients undergoing ASA vs. a group of conservatively treated patients with comparable pressure gradient and limiting symptoms.…”

Section: Discussionmentioning

confidence: 64%

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Survival after alcohol septal ablation versus conservative therapy in obstructive hypertrophic cardiomyopathy

et al. 2015

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Section: Introductionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 64%

Survival after alcohol septal ablation versus conservative therapy in obstructive hypertrophic cardiomyopathy

et al. 2015

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“…114 Finally, a Scandinavian study reported marked reductions in outflow tract gradients in response to 313 ablation procedures in 279 patients with HCM, of whom 94% had class III/IV symptoms. 115 Only 21% had class II/IV symptoms at 1 year, with little change thereafter. Estimated survival rates at 1, 5 and 10 years were 97%, 87% and 67%, respectively, and were comparable to survival rates in an age-and gendermatched population.…”

Section: Alcohol Septal Ablation In Hypertrophic Cardiomyopathymentioning

confidence: 98%

Almanac 2012: Interventional cardiology

Meier

2013

Revista Portuguesa de Cardiologia (English Edition)

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The field of interventional cardiology continues to progress quickly. The efficacy of percutaneous interventions with newer generation drug-eluting stents has advanced a lot over the last decade. This improvement in stent performance has broadened the level of indication towards more complex interventions such as left main and multivessel PCI. Major improvements continue in the field of medical co-therapy such as antiplatelet therapies (bivalirudin, prasugrel, ticagrelor) and this will further improve outcomes of PCI. The same is true for intravascular imaging such as ultrasound IVUS and optical coherence tomography OCT. However, interventional cardiology has become a rather broad field, also including alcohol septal ablation for hypertrophic obstructive cardiomyopathy, etc. At the moment, the fastest growing area is the structural interventions, especially for aortic valve stenosis (transcatheter aortic valve implantation TAVI) and for mitral regurgitation (mitral clipping). This review covers recent advances in all these different fields of interventional cardiology. PERCUTANEOUS CORONARY INTERVENTION VERSUS MEDICAL TREATMENTPercutaneous coronary intervention (PCI) has guideline recommendations for treatment of ST elevation and non-ST elevation myocardial infarction (MI). 1 However, its role in stable coronary disease has been the subject of reappraisal following publication of the COURAGE trial, which showed that, in patients receiving optimal medical therapy, PCI does not improve cardiovascular outcomes, while incremental benefits for quality of life disappear by 36 months. A more recent meta-analysis of eight trials of optimal medical therapy versus PCI involving 7229 patients bears out the COURAGE conclusions by showing no significant differences between the groups with regard to death (9.1% vs 8.9%), non-fatal MI (8.1% vs 8.9%), unplanned revascularisation (30.7% vs 21.4%) and persistent angina (33% vs 29%).4 Drug-eluting stents (DESs) were used in only a minority of these patients and may have reduced the need for further revascularisation while improving symptomatic responses. Nevertheless, the meta-analysis reinforces contemporary guideline advice for optimal medical treatment as the initial treatment for stable angina.

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“…Among the inva sive group, the pacemaker-treated group fared less well than patients treated with septal ablation or myomectomy, ques tioning the call for a reappraisal of pacemaker therapy in a recent Spanish study that reported favourable long-term results in a group of 50 patients. 114 Finally, a Scandinavian study reported marked reductions in outflow tract gradients in response to 313 ablation procedures in 279 patients with HCM, of whom 94% had class III/IV symptoms. 115 Only 21% had class II/ IV symp toms at 1 year, with little change thereafter.…”

Section: Alcohol Septal Ablation In Hypertrophic Cardiomyopathymentioning

confidence: 98%

Almanac 2012: Cardiovascular risk scores: The national society journals present selected research that has driven recent advances in clinical cardiology

Meier¹

2013

Srce i krvni sudovi

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Almanah 2012 serijaPercutaneous coronary intervention versus medical treatment P ercutaneous coronary intervention (PCI) has guide line recommendations for treatment of ST elevation and non-ST elevation myocardial infarction (MI).1 However, its role in stable coronary disease has been the subject of reappraisal following publication of the COURAGE trial, which showed that, in patients receiving optimal medical therapy, PCI does not improve cardiovascular outcomes, while incremental benefits for quality of life disappear by 36 months.2 3 A more recent meta-analysis of eight trials of optimal medical therapy versus PCI involving 7229 patients bears out the COURAGE conclusions by showing no significant differences between the groups with regard to death (9.1% vs 8.9%), non-fatal MI (8.1% vs 8.9%), unplanned revascularisation (30.7% vs 21.4%) and persistent angina (33% vs 29%).4 Drug-eluting stents (DESs) were used in only a minority of these patients and may have reduced the need for further revascularisation while improving symptomatic responses. Nevertheless, the meta-analysis reinforces contemporary guideline advice for optimal medical treatment as the initial treatment for stable angina.5 Whether this will change current practice remains to be seen, but early signs are not encouraging. Thus a US registry analysis of patients undergoing PCI before (n=173416) and after (n=293 795) the COURAGE report showed no change in the proportions receiving optimal medical treatment (43.5% vs 44.7%). 6 PCI versus coronary bypass surgery

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Long-Term Outcome of Percutaneous Transluminal Septal Myocardial Ablation in Hypertrophic Obstructive Cardiomyopathy

Cited by 93 publications

References 34 publications

Survival after alcohol septal ablation versus conservative therapy in obstructive hypertrophic cardiomyopathy

Survival after alcohol septal ablation versus conservative therapy in obstructive hypertrophic cardiomyopathy

Almanac 2012: Interventional cardiology

Almanac 2012: Cardiovascular risk scores: The national society journals present selected research that has driven recent advances in clinical cardiology

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