Septal alcohol ablation as a treatment for hypertrophic obstructive cardiomyopathy. Case Report
Article Sidebar
Main Article Content
Abstract
Hypertrophic cardiomyopathy is a genetic disease, the most serious event of which is sudden death.
Diagnosis is based on imaging findings, noting a hypertrophic undilated left ventricle, in the absence of other pathologies that may explain these alterations. The objective of the medical treatment is to improve functional disability and diastolic filling. In those patients who continue to be symptomatic despite drug treatment, with significant left ventricular outflow tract obstruction, septal myomectomy
is recommended; however, septal alcohol ablation is an alternative to surgery.
We present a 39-year-old patient with syncope and heart failure, with an image-confirmed diagnosis of hypertrophic obstructive cardiomyopathy, in whom symptoms persisted despite medical treatment, for which septal alcohol ablation was performed, obtaining satisfactory results.
Hypertrophic obstructive cardiomyopathy has been considered a rare pathology, however, it is currently being diagnosed more and more, thanks to the greater knowledge of its phenotypic expression. Septal alcohol ablation has proven to be a safe and effective option in our setting, constituting a reasonable alternative treatment to surgery in selected patients.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Fernández A, Casabé JH, Coronel R, Galizio N, Torino A, et al. Alternativas terapéuticas en la miocardiopatía hipertrófica. Rev Argent Cardiol. 2003;71(4):294–301.
Estrada A, Brenna E, Contreras A, Amuchástegui M, Estrada C, Caeiro A, et al. Miocardiopatía hipertrófica: ¿cómo evaluamos en 2018 el riesgo de muerte súbita? Rev Uruguaya Cardiol. 2018;33(3):350–9. doi: 10.29277/cardio.33.3.19.
Casabé H, Acunzo R, Fernández A, Gabay J, Galizio N. Consenso de Miocardiopatía Hipertrófica. Rev Argent Cardiol. 2009;77(2):1–28.
Perry ME, Anastasakis A, Borger MA, Borggrefe M, Cecchi F, Charron P, et al. Guía de práctica clínica de la ESC 2014 sobre el diagnóstico y manejo de la miocardiopatía hipertrófica. Rev Esp Cardiol. 2015;68(1):1–52. doi: 10.1016/j.recesp.2014.12.001.
López-Aburto G, Palacios-Rodríguez JM, Cantú-Ramírez S, Galván-García E, Tolosa-Dzul G, Morán-Benavente A, et al. Ablación septal con alcohol para tratar miocardiopatía hipertrófica. Rev Med Inst Mex Seguro Soc. 2013;51(4):396–401.
Castedo E, Cabo R, Núñez I, Monguió E, Montero C, Burgos R, et al. Tratamiento quirúrgico de la miocardiopatía hipertrófica obstructiva. Rev Esp Cardiol. 2004;57(8):751–6. doi: 10.1157/13064827.
Delgado V, Sitges M, Andrea R, Rivera S, Masotti M, Francino A, et al. Seguimiento clínico y ecocardiográfico de pacientes con miocardiopatía hipertrófica obstructiva tratados con ablación septal percutánea. Rev Española Cardiol. 2006;59(11):1123–30. doi: 10.1157/13095781.
de la Torre Hernandez JM, Masotti Centol M, Lerena Saenz P, Sánchez Recalde Á, Gimeno de Carlos F, Piñón Esteban P, et al. Eficacia y seguridad a más de 10 años de la ablación septal percutánea en la miocardiopatía hipertrófica obstructiva. Rev Española Cardiol. 2014;67(5):353–358. doi: 10.1016/j.recesp.2013.09.005.