P4588Echo guided septal radiofrequency ablation for treatment of obstructive hypertrophic cardiomiopathy - Case series

Valdigem, Bruno Pereira; Correa, Edileide B; Moreira, Dalmo Antônio Ribeiro; Andalaft, Rogério Braga; Pinto, Ibraim; Abizaid, Alexandre; Cano, Manuel; Armaganijan, Luciana; Filho, Tavares; Verissimo, O; Lebihan, D; Feres, Fausto; Viesi, João Henrique Zucco; Neto, Caetano Nigro; Barreto, Rodrigo

doi:10.1093/eurheartj/ehy563.p4588

Cited by 2 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Для улучшения функционального состояния, уменьшения выраженности симптомов и профилактики прогрессирования заболевания следует назначать лекарственную терапию, включающую бета-блокаторы и/или верапамил, дизопирамид, антиаритмические препараты и диуретики [5]. Однако больные ГОКМП, у которых, несмотря на максимально возможную медикаментозную терапию, сохраняются выраженные симптомы, становятся кандидатами на инвазивные вмешательства, в том числе на установку постоянного электрокардиостимулятора, чрескожную септальную редукцию или септальную миоэктомию [1].…”

Section: Discussionunclassified

“…1). Радиочастотную аблацию осуществляли по протоколу нашей клиники до снижения градиента давления в ВТ ЛЖ на 40% от исходных величин (его измеряли интраоперационно с помощью чреспищеводной ЭхоКГ и катетера типа «пигтэйл», подведенного к верхушке ЛЖ и ВТ ЛЖ), как описано ранее [5].…”

Section: описание клинического наблюденияunclassified

See 1 more Smart Citation

Anesthetic management during endocardial radiofrequency ablation of septal hypertrophy – a case report

et al. 2019

View full text Add to dashboard Cite

Background: Hypertrophic cardiomyopathy (HCM) is a genetic disorder present in up to 1/500 individuals, about 20–30% of them presenting with hypertrophic obstructive cardiomyopathy (HOCM) due to left ventricle outflow tract obstruction. This is an important cause of sudden cardiac death. Endocardial radiofrequency ablation of septal hypertrophy (ERASH) might be an attractive treatment for HOCM, particularly in patients who do not respond to transcoronary alcohol septal ablation (TASA).Aim: To describe technical aspects related to the procedure and anesthetic management of an ERASH case.Case report: A 64-year-old woman with HOCM was scheduled for ERASH. She had worsening of dyspnea on exertion and generalized fatigue for the previous weeks after previous surgical myomectomy about 6 months ago. The anatomy was unfavorable for TASA and the patient was not willing to undergo another surgery. Preoperative transthoracic echocardiography (TTE) showed asymmetric mid-septal hypertrophy, systolic anterior motion with septal contact and left ventricular outflow tract maximum gradient of 68 mmHg at rest and 105 mmHg after the Valsalva maneuver. General anesthesia was performed. Pulse pressure variation, echocardiography parameters and passive leg raising test where used to guide fluid therapy. At the end of the procedure, analgesia was provided together with prophylaxis of nausea and vomiting. Extubation was uneventful and the patient was transported to the intensive care unit eupneic and hemodynamically stable. On the fourth postoperative day, TTE showed septal hypocontractility and maximum gradient reduction of 33% at rest (68 mmHg to 45 mmHg) and 31% after the Valsalva maneuver (105 mmHg to 73 mmHg). The patient was discharged from hospital at the sixth postoperative day. One month later, she reported progressive improvement of symptoms and expressed satisfaction with the results.Conclusion: Better understanding of the pathophysiology and natural history of HCM has enabled earlier diagnosis, as well as a more adequate therapeutic approach. Anesthesiologists should be aware of the pathophysiology of HOCM and must be prepared to anticipate the hemodynamic changes and cardiovascular instability that such patients may show perioperatively. ERASH is a promising therapeutic modality increasingly used for HOCM and anesthesiologists should become more familiar with it.

show abstract

Section: Discussionunclassified

Section: описание клинического наблюденияunclassified

Anesthetic management during endocardial radiofrequency ablation of septal hypertrophy – a case report

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The loss of this region can lead to right bundle branch block, a common complication after alcohol septal ablation, 16 which can be avoided in some cases when the choice of coronary anatomy is guided by echocardiographic contrast. 17 Cardiac magnetic resonance imaging CMR is in the process of being consolidated as a necessary method in HCM as it provides diagnostic and prognostic information. The high spatial and temporal resolution makes it possible to measure the dimensions of the cavity and ventricular walls with high precision (Figure 4A).…”

Section: Coneglian Et Al Diagnosis and Treatment Of Hypertrophic Card...mentioning

confidence: 99%

Diagnosis and Treatment of Hypertrophic Cardiomyopathy

Saraiva¹,

Fernandes²,

Romano³

et al. 2023

ABC Heart Fail Cardiomyop

View full text Add to dashboard Cite

The concept of hypertrophic cardiomyopathy has undergone profound changes with the advent of cardiogenomics and the increase in knowledge about the sarcomeric structure and the mutations that lead to cardiomyocyte hypertrophy. In this review article, we address the state of the art in terms of diagnosis, contemplating the genetic heart diseases responsible for differential diagnoses of hypertrophic cardiomyopathy, known as phenocopies, which are a major challenge in clinical practice. We also discuss the current evidence that guides treatment.

show abstract

P4588Echo guided septal radiofrequency ablation for treatment of obstructive hypertrophic cardiomiopathy - Case series

Cited by 2 publications

References 0 publications

Anesthetic management during endocardial radiofrequency ablation of septal hypertrophy – a case report

Anesthetic management during endocardial radiofrequency ablation of septal hypertrophy – a case report

Diagnosis and Treatment of Hypertrophic Cardiomyopathy

Contact Info

Product

Resources

About