PMID- 10677415
OWN - NLM
STAT- MEDLINE
DCOM- 20000329
LR  - 20190503
IS  - 1355-6037 (Print)
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 83
IP  - 3
DP  - 2000 Mar
TI  - Percutaneous transluminal septal myocardial ablation for hypertrophic obstructive 
      cardiomyopathy: long term follow up of the first series of 25 patients.
PG  - 326-31
AB  - OBJECTIVE: To determine the long term outcome in patients treated with 
      percutaneous transluminal septal myocardial ablation (PTSMA) for hypertrophic 
      obstructive cardiomyopathy (HOCM). DESIGN AND SETTING: Observational, single 
      centre study. PATIENTS: 25 patients (13 women, 12 men, mean (SD) age 54.7 (15.0) 
      years) with drug treatment resistant New York Heart Association (NYHA) class 2.8 
      (0. 6) symptoms attributed to a high left ventricular outflow gradient (LVOTG) 
      and a coronary artery anatomy suitable for intervention. INTERVENTION: PTSMA by 
      injection of 4.1 (2.6) ml of alcohol (96%) into 1.4 (0.6) septal perforator 
      arteries to ablate the hypertrophied interventricular septum. OUTCOME MEASURES: 
      During in-hospital follow up, enzyme rise, the frequency of atrioventricular 
      conduction lesions requiring permanent DDD pacing, and in-hospital mortality were 
      assessed. Long term follow up (30 (4) months, range 24-36 months) included 
      symptoms, echocardiographic measurements of left atrial and left ventricular 
      dimensions and function, and LVOTG. RESULTS: Mean postinterventional creatine 
      kinase rise was 780 (436) U/l. During PTSMA 13 patents developed total heart 
      block, permanent pacing being necessary in five of them. One 86 year old patient 
      died from ventricular fibrillation associated with intensive treatment (beta 
      mimetic and theophylline) for coexistent severe obstructive airway disease. After 
      three months, three patients underwent re-PTSMA because of a dissatisfactory 
      primary result, leading to LVOTG elimination in all of them. During long term 
      follow up, LVOTG showed sustained reduction (3 (6) mm Hg at rest and 12 (19) mm 
      Hg with provocation) associated with stable symptomatic improvement (NYHA class 
      1.2 (1.0)) and without significant global left ventricular dilatation. 
      CONCLUSIONS: PTSMA is an effective non-surgical technique for reduction of 
      symptoms and LVOTG in HOCM. Prospective, long term observations of larger 
      populations are necessary in order to determine the definitive significance of 
      the procedure.
FAU - Faber, L
AU  - Faber L
AD  - Department of Cardiology, Heart Center NRW, Ruhr-University of Bochum, 
      Georgstrasser 11, D-32545 Bad Oeynhausen, Germany.
FAU - Meissner, A
AU  - Meissner A
FAU - Ziemssen, P
AU  - Ziemssen P
FAU - Seggewiss, H
AU  - Seggewiss H
LA  - eng
PT  - Journal Article
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
RN  - 0 (Solvents)
RN  - 3K9958V90M (Ethanol)
SB  - IM
CIN - Heart. 2000 Mar;83(3):255-6. PMID: 10677397
MH  - Angioplasty, Balloon, Coronary
MH  - Cardiomyopathy, Hypertrophic/*therapy
MH  - Coronary Angiography
MH  - Echocardiography
MH  - Ethanol/*therapeutic use
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Sclerotherapy/*methods
MH  - Solvents/*therapeutic use
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/*therapy
PMC - PMC1729336
EDAT- 2000/03/04 09:00
MHDA- 2000/04/01 09:00
PMCR- 2003/03/01
CRDT- 2000/03/04 09:00
PHST- 2000/03/04 09:00 [pubmed]
PHST- 2000/04/01 09:00 [medline]
PHST- 2000/03/04 09:00 [entrez]
PHST- 2003/03/01 00:00 [pmc-release]
AID - 10.1136/heart.83.3.326 [doi]
PST - ppublish
SO  - Heart. 2000 Mar;83(3):326-31. doi: 10.1136/heart.83.3.326.