Septal reduction therapy using nonalcohol agent in hypertrophic obstructive cardiomyopathy: Single center experience

Asil, Serkan; Kaya, Barış; Canpolat, Uğur; Yorgun, Hikmet; Şahiner, Levent; Çöteli, Cem; Arat, Anıl; Aytemir, Kudret

doi:10.1002/ccd.27442

Cited by 3 publications

(6 citation statements)

References 35 publications

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“…4,8,[19][20][21] Due to the high frequency of procedure-related complications with ASA, a need exists for percutaneous ablation techniques with alternative septal embolization agents. 15 The most common conduction system problem after ASA is the development of RBBB, and studies showed that RBBB does not affect prognosis. 22 Researchers even showed that the development of RBBB may be correlated with the necrotic area's size and the procedure's success.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the nonadhesive property of EVOH, the filling of the septal artery was checked under fluoroscopy or angiography during its injection. After the occlusion of the septal artery, the microcatheter, and the whole system were withdrawn together 15 (Figure 2).…”

Section: Evoh-dmso Septal Ablation Proceduresmentioning

confidence: 99%

“…For this purpose, many substances such as coil, polyvinyl alcohol particles, radiofrequency, endocardial ablation with cryo, gelatin particles, glue, and Ethylene-vinyl alcohol (EVOH)-dimethyl sulfoxide (DMSO) were used. [10][11][12][13][14][15] The agents preferred for this purpose generate ischemic necrosis, whose necrosis borders, and pathophysiology are more clearly known than chemical necrosis. However, some Sonuç: EVOH-DMSO, diğer alternatif ajanlardan daha yaygın, ancak alkol septal ablasyondan daha az iletim sistemi sorunlarına neden olabilmektedir.…”

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confidence: 99%

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Predictive Value of the SCORE, SCORE2, and Pooled Cohort Risk Equation Systems in Patients with Hypertension

Asil¹

2023

Arch Turk Soc Cardiol

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Objective: Surgical septal myectomy and alcohol septal ablation are recommended treatment modalities for alleviating Left ventricular outflow tract (LVOT) gradient in obstructive HCM.Alcohol septal ablation offers advantages over surgery in many ways. However, it is associated with some life-threatening complications. For this purpose, our center used alternative agents for septal artery embolization. This study compared and evaluated conduction system defects and arrhythmia risk after EVOH-DMSO septal ablation with other alternative agents and alcohol septal ablation.Methods: Twenty-five patients who received septal reduction therapy with EVOH-DMSO were analyzed retrospectively, and all non-alcoholic agent's septal ablation studies were systematically reviewed and compared.Results: Twenty-five patients (52% female; mean age: 55.8 ± 17.1) with symptomatic obstructive HCM were enrolled. The Peak LVOT gradient was significantly reduced after the procedure (68 vs. 20 mmHg; P <0.001). During the 12-month follow-up, no mortality occurred.The complete atrioventricular block was noted in 2 (8%) patients. The incidence of right bundle branch block (RBBB) increased after the procedure (pre-procedural 2 patients (8%), post-procedural 9 patients (36%) P = 0.002). On ECG and Holter monitorization, no sustained ventricular tachyarrhythmia occurred during follow-up, and no change was found in the frequency of atrial fibrillation. We systematically compared EVOH-DMSO to other non-alcohol agents, and we found that EVOH-DMSO can cause conduction system problems more commonly than other non-alcohol agents.Conclusion: EVOH-DMSO could cause conduction system problems more common than other non-alcohol agents but less than alcohol septal ablation.

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Section: Discussionmentioning

confidence: 99%

Section: Evoh-dmso Septal Ablation Proceduresmentioning

confidence: 99%

mentioning

confidence: 99%

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Predictive Value of the SCORE, SCORE2, and Pooled Cohort Risk Equation Systems in Patients with Hypertension

Asil¹

2023

Arch Turk Soc Cardiol

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Section: Alcohol Septal Ablationmentioning

confidence: 99%

“…Koljaja-Batzner et al, previously published a case report on the treatment of a female patient in her sixties with ASA, who was hospitalized for 9 months and had no problems [ 40 - 44 ]. Asil et al, verified no mortality throughout the 12-month follow-up period [ 44 ]. Bytyçi et al confirmed their findings, indicating that periprocedural issues were less common with alcohol ablation, even though reintervention and pacemaker implants were more common therein [ 42 - 44 ].…”

Section: Alcohol Septal Ablationmentioning

confidence: 99%

A Narrative Review of Emerging Therapies for Hypertrophic Obstructive Cardiomyopathy

Menezes

Oliveira

Taia

et al. 2023

CCR

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Hypertrophic obstructive cardiomyopathy is a hereditary condition that affects myocardial contraction. In case of failure of pharmacological treatment, alternative approaches might be used that include surgical myectomy, percutaneous transluminal septal myocardial ablation, and radiofrequency ablation. In respect of long-term advantages, surgical septal myectomy remains the therapy of choice for symptomatic hypertrophic obstructive cardiomyopathy. Alcohol septal ablation has been considered an alternative to surgical myectomy, which confers the benefits of a shorter hospital stay, less discomfort, and fewer complications. However, only expert operators should perform it on carefully chosen patients. Further, radiofrequency septal ablation reduces the left ventricular outflow tract gradient and improves the NYHA functional class of patients with hypertrophic obstructive cardiomyopathy, despite complications like cardiac tamponade and atrioventricular block. Further research with a larger sample size is required to compare the radiofrequency approach with established invasive treatment methods for hypertrophic obstructive cardiomyopathy. Septal myectomy has low morbidity and mortality rates, making it the preferred procedure; however, the efficacy and morbidity remain debatable. Advances in invasive techniques, including percutaneous septal radiofrequency ablation and transcatheter myotomy, have provided alternative approaches for reducing left ventricular outflow tract (LVOT) obstruction in patients who are not candidates for traditional surgical septal myectomy. Candidates for alcohol and radiofrequency septal ablation include patients with symptomatic hypertrophic obstructive cardiomyopathy, older adults, and those with multiple comorbidities.

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Single Center Experience of Percutaneous Septal Ablation in Patients With Hypertrophic Cardiomyopathy With A Novel Agent: Polidocanol

Ateş

Şener

Şahiner

et al. 2023

The American Journal of Cardiology

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Septal reduction therapy using nonalcohol agent in hypertrophic obstructive cardiomyopathy: Single center experience

Abstract: In conclusion, our small-sized preliminary study results showed that septal reduction therapy using EVOH is an effective alternative option in reducing symptoms and LVOT gradient in HOCM.

Cited by 3 publications

References 35 publications

Predictive Value of the SCORE, SCORE2, and Pooled Cohort Risk Equation Systems in Patients with Hypertension

Predictive Value of the SCORE, SCORE2, and Pooled Cohort Risk Equation Systems in Patients with Hypertension

A Narrative Review of Emerging Therapies for Hypertrophic Obstructive Cardiomyopathy

Single Center Experience of Percutaneous Septal Ablation in Patients With Hypertrophic Cardiomyopathy With A Novel Agent: Polidocanol

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