Article ; Online: Comparative Evaluation of Alcohol Septal Ablation: Left Anterior Descending Versus Non-left Anterior Descending Artery Approaches.
The American journal of cardiology
2024 Volume 216, Page(s) 54–62
Abstract: Alcohol septal ablation (ASA) is performed for symptomatic drug-refractory hypertrophic obstructive cardiomyopathy to reduce the left ventricular outflow tract pressure gradient (LVOTPG) by injecting ethanol into a septal branch that perforates the ... ...
| Abstract | Alcohol septal ablation (ASA) is performed for symptomatic drug-refractory hypertrophic obstructive cardiomyopathy to reduce the left ventricular outflow tract pressure gradient (LVOTPG) by injecting ethanol into a septal branch that perforates the septal bulge. The target septal branches usually arise directly from the left anterior descending (LAD) artery; however, vessels from a non-LAD artery can be selected in some cases. This study aimed to compare the effectiveness and safety between ASA performed using a septal branch arising from a non-LAD artery and a branch arising from the LAD artery. This single-center, retrospective, observational cohort study comprised patients with hypertrophic obstructive cardiomyopathy who underwent ASA at the Gifu Heart Centre between 2011 and 2022. The effectiveness and safety of ASA using the 2 artery types were compared. The primary end points were LVOTPG and procedure success, determined as LVOTPG <30 mm Hg after 1 year. Of 33 patients (mean age 66.4 ± 13.0 years, 13 men), 18 patients who underwent ASA using only LAD branches and 15 patients who underwent ASA using only non-LAD branches demonstrated no significant difference in the decrease in LVOTPG during the follow-up period (-99.1 ± 47.4 mm Hg/year vs -75.7 ± 39.2 mm Hg/year, respectively, p = 0.19). The procedure success at 1 year was not significantly different between the 2 groups (93.3% and 84.6%, respectively, p = 0.58). ASA performed using septal branches from non-LAD arteries could be an alternative treatment approach when appropriate septal branches are missing or desirable effects cannot be obtained from ASA using LAD branches. |
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| MeSH term(s) | Aged ; Humans ; Male ; Middle Aged ; Ablation Techniques ; Cardiomyopathy, Hypertrophic ; Coronary Vessels/diagnostic imaging ; Coronary Vessels/surgery ; Ethanol/therapeutic use ; Heart Septum/surgery ; Retrospective Studies ; Treatment Outcome ; Female |
| Chemical Substances | Ethanol (3K9958V90M) |
| Language | English |
| Publishing date | 2024-02-23 |
| Publishing country | United States |
| Document type | Observational Study ; Journal Article |
| ZDB-ID | 80014-4 |
| ISSN | 1879-1913 ; 0002-9149 |
| ISSN (online) | 1879-1913 |
| ISSN | 0002-9149 |
| DOI | 10.1016/j.amjcard.2024.01.034 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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