A repeat alcohol septal ablation procedure for hypertrophic obstructive cardiomyopathy where the first septal branch arose from the intermediate (Ramus) artery

Doran, Grainne C., Burns, Catherine M., Murdoch, Dale J., Incani, Alexander and Walters, Darren L. (2013) A repeat alcohol septal ablation procedure for hypertrophic obstructive cardiomyopathy where the first septal branch arose from the intermediate (Ramus) artery. Heart Lung and Circulation, 22 12: 1026-1029. doi:10.1016/j.hlc.2013.03.081


Author Doran, Grainne C.
Burns, Catherine M.
Murdoch, Dale J.
Incani, Alexander
Walters, Darren L.
Title A repeat alcohol septal ablation procedure for hypertrophic obstructive cardiomyopathy where the first septal branch arose from the intermediate (Ramus) artery
Journal name Heart Lung and Circulation   Check publisher's open access policy
ISSN 1443-9506
1444-2892
Publication date 2013-01-01
Year available 2013
Sub-type Article (original research)
DOI 10.1016/j.hlc.2013.03.081
Open Access Status Not Open Access
Volume 22
Issue 12
Start page 1026
End page 1029
Total pages 4
Place of publication Chatswood, NSW Australia
Publisher Elsevier Australia
Language eng
Subject 2705 Cardiology and Cardiovascular Medicine
2740 Pulmonary and Respiratory Medicine
Abstract Septal reduction therapy (via alcohol septal ablation or surgical myomectomy) is indicated in patients with hyper- trophic obstructive cardiomyopathy (HOCM) who have NYHA class III/IV symptoms despite maximal medical therapy. In 90% of patients with HOCM the target septal artery arises from the LAD or diagonal artery. In the remaining 10% of cases it may arise from the ramus, proximal circumflex, or posterolateral or posterior descending branches of the RCA. We present a case where alcohol septal ablation was initially performed on the first septal branch arising from the left anterior descending artery. Left ventricular outflow tract (LVOT) obstruction with symptoms recurred. Upon repeat angiography, a large septal branch in fact arose from the proximal intermediate (ramus) artery. Alcohol ablation of this branch achieved a sustained response. This case highlights that correctly identifying the most suitable septal perforating artery, in addition to myocardial contrast echocardiography, may improve response rates and overall outcomes for patients with hypertrophic obstructive cardiomyopathy.
Keyword Alcohol septal ablation
Contrast echocardiography
Hypertrophic cardiomyopathy
Intervention
Q-Index Code CX
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Medicine Publications
 
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