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Indications for and Individualization of Septal Reduction Therapy

  • Dmitriy N. Feldman
  • John S. DouglasJr.
  • Srihari S. Naidu
Chapter

Abstract

The importance of left ventricular outflow tract obstruction in a large subset of patients with HCM and drug-refractory symptoms, as well as the value of septal reduction therapy (surgical myectomy or alcohol septal ablation), has been demonstrated. However, determining the precise cause of symptoms in the HCM patient, and specifically implicating outflow tract obstructive physiology, can be quite challenging. Accordingly, a detailed and comprehensive morphologic and physiologic evaluation of the HCM patient is of paramount importance to determine which patients may benefit from septal reduction therapy. Patients should be considered for septal reduction therapy when (a) symptoms are clearly and primarily attributed to obstructive HCM despite optimal medical therapy, (b) symptoms encompass severe heart failure or angina (NYHA or CCS class III/IV), recurrent obstruction-related syncope, or recurrent clinical decompensation due to refractory paroxysmal atrial fibrillation, (c) a gradient ≥50 mmHg can be demonstrated on optimal medical therapy, and (d) obstruction is clearly dynamic and subvalvular, resulting mainly from septum-to-anterior mitral leaflet contact. Surgical myectomy has been the traditional gold-standard invasive therapy. Alcohol septal ablation (ASA) is a minimally invasive catheter-based alternative with less patient discomfort and more rapid recovery; however, only patients with certain anatomic criteria are candidates. Evidence from non-randomized studies suggests that ASA and surgical myectomy result in similar short- and long-term outcomes with respect to hemodynamic and functional improvements, with greater propensity for pacemaker placement with septal ablation. Based on comprehensive assessment of clinical symptoms, associated co-morbidities, echocardiographic, electrocardiographic, and angiographic features, some patients are better suited for myectomy while others are better suited for ASA. This chapter will review indications for septal reduction therapy and how to individualize the selection of the appropriate septal reduction procedure in clinical practice.

Keywords

Myectomy Alcohol septal ablation Septal reduction Indication 

References

  1. 1.
    Brock RC. Functional obstruction of the left ventricle (acquired aortic subvalvar stenosis). Guys Hosp Rep. 1957;106:221.PubMedGoogle Scholar
  2. 2.
    Braunwald E, Lambrew CT, Rockoff SD, Ross Jr J, Morrow AG. Idiopathic hypertrophic subaortic stenosis. I. A description of the disease based upon an analysis of 64 patients. Circulation. 1964;29 Suppl 4:3–119.Google Scholar
  3. 3.
    Wigle ED, Lenkei SC, Chrysohou A, Wilson DR. Muscular subaortic stenosis: the effect of peripheral vasodilatation. Can Med Assoc J. 1963;89:896–9.PubMedCentralPubMedGoogle Scholar
  4. 4.
    Criley JM, Lewis KB, White RI, Ross RS. Pressure gradients without obstruction: a new concept of “hypertrophic subaortic stenosis.”. Circulation. 1964;32:881–7.CrossRefGoogle Scholar
  5. 5.
    Maron BJ, Epstein SE. Clinical significance and therapeutic implications of the left ventricular outflow tract pressure gradient in hypertrophic cardiomyopathy. Am J Cardiol. 1986;58:1093–6.PubMedCrossRefGoogle Scholar
  6. 6.
    Spirito P, Maron BJ. Patterns of systolic anterior motion of the mitral valve in hypertrophic cardiomyopathy: assessment of two-dimensional echocardiography. Am J Cardiol. 1984;54:1039–46.PubMedCrossRefGoogle Scholar
  7. 7.
    Maron MS, Olivotto I, Betocchi S, et al. Effect of left ventricular outflow tract obstruction on clinical outcome in hypertrophic cardiomyopathy. N Engl J Med. 2003;348:295–303.PubMedCrossRefGoogle Scholar
  8. 8.
    Maron MS, Olivotto I, Zenovich AG, et al. Hypertrophic cardiomyopathy is predominantly a disease of left ventricular outflow tract obstruction. Circulation. 2006;114:2232–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Autore C, Bernabò P, Barillà CS, Bruzzi P, Spirito P. The prognostic importance of left ventricular outflow obstruction in hypertrophic cardiomyopathy varies in relation to the severity of symptoms. J Am Coll Cardiol. 2005;45:1076–80.PubMedCrossRefGoogle Scholar
  10. 10.
    Elliott PM, Gimeno JR, Tomé MT, et al. Left ventricular outflow tract obstruction and sudden death risk in patients with hypertrophic cardiomyopathy. Eur Heart J. 2006;27:1933–41.PubMedCrossRefGoogle Scholar
  11. 11.
    Woo A, Williams WG, Choi R, et al. Clinical and echocardiographic determinants of long-term survival after surgical myectomy in obstructive hypertrophic cardiomyopathy. Circulation. 2005;111:2033–41.PubMedCrossRefGoogle Scholar
  12. 12.
    Maron BJ, Dearani JA, Ommen SR, et al. The case for surgery in obstructive hypertrophic cardiomyopathy. J Am Coll Cardiol. 2004;44:2044–53.PubMedCrossRefGoogle Scholar
  13. 13.
    Maron BJ, Maron MS, Wigle ED, Braunwald E. The 50-year history, controversy, and clinical implications of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy: From idiopathic hypertrophic subaortic stenosis to hypertrophic cardiomyopathy. J Am Coll Cardiol. 2009;54:191–200.PubMedCrossRefGoogle Scholar
  14. 14.
    Spirito P, Maron BJ, Rosing DR. Morphologic determinants of hemodynamic state after ventricular septal myectomy-myectomy in patients with obstructive hypertrophic cardiomyopathy: M-mode and two-dimensional echocardiographic assessment. Circulation. 1984;70:984–95.PubMedCrossRefGoogle Scholar
  15. 15.
    Nasseri BA, Stamm C, Siniawski H, Kukucka M, Komoda T, Delmo Walter EM, et al. Combined anterior mitral valve leaflet retention plasty and septal myectomy in patients with hypertrophic obstructive cardiomyopathy. Eur J Cardiothorac Surg. 2011;40:1515–20.PubMedGoogle Scholar
  16. 16.
    Schulte HD, Bircks WH, Loesse B, Godehardt EA, Schwartzkopff B. Prognosis of patients with hypertrophic obstructive cardiomyopathy after transaortic myectomy. Late results up to 25 years. J Thorac Cardiovasc Surg. 1993;106:709–17.PubMedGoogle Scholar
  17. 17.
    Robbins RC, Stinson EB. Long-term results of left ventricular myotomy and myectomy for obstructive hypertrophic cardiomyopathy. J Thorac Cardiovasc Surg. 1996;11:586–94.CrossRefGoogle Scholar
  18. 18.
    Smedira NG, Lytle BM, Lever HM, Rajeswaran J, Krishnaswamy G, Kaple RK, Dolney DO, Blackstone EH. Current effectiveness and risks of isolated septal myectomy for hypertrophic obstructive cardiomyopathy. Ann Thorac Surg. 2008;85:127–33.PubMedCrossRefGoogle Scholar
  19. 19.
    Dearani JA, Ommen SR, Gersh BJ, Schaff HV, Danielson GK. Surgery insight: septal myectomy for obstructive hypertrophic cardiomyopathy—the Mayo Clinic experience. Nat Clin Pract Cardiovasc Med. 2007;4:503–12.PubMedCrossRefGoogle Scholar
  20. 20.
    Ommen SR, Maron BJ, Olivotto I, Maron MS, Cecchi F, Betocchi S, Gersh BJ, Ackerman MJ, McCully RB, Dearani JA, Schaff HV, Danielson GK, Tajik AJ, Nishimura RA. Long-term effects of surgical septal myectomy on survival in patients with obstructive hypertrophic cardiomyopathy. J Am Coll Cardiol. 2005;46:470–6.PubMedCrossRefGoogle Scholar
  21. 21.
    Sigwart U. Non-surgical myocardial reduction for hypertrophic obstructive cardiomyopathy. Lancet. 1995;346:211–14.PubMedCrossRefGoogle Scholar
  22. 22.
    Lakkis NM, Nagueh SF, Dunn JK, Killip D, Spencer 3rd WH. Nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy: one-year follow-up. J Am Coll Cardiol. 2000;36:852–5.PubMedCrossRefGoogle Scholar
  23. 23.
    Kim JJ, Lee CW, Park SW, Hong MK, Lim HY, Song JK, Jin YS, Park SJ. Improvement in exercise capacity and exercise blood pressure response after transcoronary alcohol ablation therapy of septal hypertrophy in hypertrophic cardiomyopathy. Am J Cardiol. 1999;83:1220–3.PubMedCrossRefGoogle Scholar
  24. 24.
    Chen J, Nagaraj H, Bhambhani P, Kliner DE, Soman P, Garcia EV, et al. Effect of alcohol septal ablation in patients with hypertrophic cardiomyopathy on left-ventricular mechanical dyssynchrony as assessed by phase analysis of gated SPECT myocardial perfusion imaging. Int J Cardiovasc Imaging. 2011. doi: 10.1007/s10554-011-9942-y.Google Scholar
  25. 25.
    Timmer SA, Knaapen P, Germans T, Dijkmans PA, Lubberink M, Ten Berg JM, et al. Effects of alcohol septal ablation on coronary microvascular function and myocardial energetics in hypertrophic obstructive cardiomyopathy. Am J Physiol Heart Circ Physiol. 2011;301:H129–37.PubMedCrossRefGoogle Scholar
  26. 26.
    Mazur W, Nagueh SF, Lakkis NM, Middleton KJ, Killip D, Roberts R, Spencer 3rd WH. Regression of left ventricular hypertrophy after nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy. Circulation. 2001;103:1492–6.PubMedCrossRefGoogle Scholar
  27. 27.
    Faber L, Seggewiss H, Gleichmann U. Percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy: results with respect to intraprocedural myocardial contrast echocardiography. Circulation. 1998;98:2415–21.PubMedCrossRefGoogle Scholar
  28. 28.
    Gietzen FH, Leuner CJ, Raute-Kreinsen U, Dellmann A, Hegselmann J, Strunk-Mueller C, Kuhn HJ. Acute and long-term results after transcoronary ablation of septal hypertrophy (TASH). Catheter interventional treatment for hypertrophic obstructive cardiomyopathy. Eur Heart J. 1999;20:1342–54.PubMedCrossRefGoogle Scholar
  29. 29.
    Nagueh SF, Lakkis NM, Middleton KJ, Killip D, Zoghbi WA, Quinones MA, Spencer 3rd WH. Changes in left ventricular filling and left atrial function six months after nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy. J Am Coll Cardiol. 1999;34:1123–8.PubMedCrossRefGoogle Scholar
  30. 30.
    Sitges M, Shiota T, Lever HM, Qin JX, Bauer F, Drinko JK, Agler DA, Martin MG, Greenberg NL, Smedira NG, Lytle BW, Tuzcu EM, Garcia MJ, Thomas JD. Comparison of left ventricular diastolic function in obstructive hypertrophic cardiomyopathy in patients undergoing percutaneous septal alcohol ablation versus surgical myotomy/myectomy. Am J Cardiol. 2003;91:817–21.PubMedCrossRefGoogle Scholar
  31. 31.
    Boekstegers P, Steinbigler P, Molnar A, Schwaiblmair M, Becker A, Knez A, Haberl R, Steinbeck G. Pressure-guided nonsurgical myocardial reduction induced by small septal infarctions in hypertrophic obstructive cardiomyopathy. J Am Coll Cardiol. 2001;38:846–53.PubMedCrossRefGoogle Scholar
  32. 32.
    Sorajja P, Ommen SR, Holmes Jr DR, Dearani JA, Rihal CS, Gersh BJ, Lennon RJ, Nishimura RA. Survival after alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Circulation. 2012;126:2374–80.PubMedCrossRefGoogle Scholar
  33. 33.
    Olivotto I, Maron BJ, Montereggi A, et al. Prognostic value of systemic blood pressure response during exercise in a community-based patient population with hypertrophic cardiomyopathy. J Am Coll Cardiol. 1999;33:2044–51.PubMedCrossRefGoogle Scholar
  34. 34.
    Sadoul N, Prasad K, Elliott PM, et al. Prospective prognostic assessment of blood pressure response during exercise in patients with hypertrophic cardiomyopathy. Circulation. 1997;96:2987–91.PubMedCrossRefGoogle Scholar
  35. 35.
    Frenneaux MP, Counihan PJ, Caforio AL, et al. Abnormal blood pressure response during exercise in hypertrophic cardiomyopathy. Circulation. 1990;82:1995–2002.PubMedCrossRefGoogle Scholar
  36. 36.
    Jones S, Elliott PM, Sharma S, McKenna WJ, Whipp BJ. Cardiopulmonary responses to exercise in patients with hypertrophic cardiomyopathy. Heart. 1998;80:60–7.PubMedCentralPubMedCrossRefGoogle Scholar
  37. 37.
    Chikamori T, Counihan PJ, Doi YL, Takata J, Stewart JT, Frenneaux MP, McKenna WJ. Mechanisms of exercise limitation in hypertrophic cardiomyopathy. J Am Coll Cardiol. 1992;19:507–12.PubMedCrossRefGoogle Scholar
  38. 38.
    Maron BJ, Bonow RO, Cannon 3rd RO, Leon MB, Epstein SE. Hypertrophic cardiomyopathy. Interrelations of clinical manifestations, pathophysiology, and therapy (2). N Engl J Med. 1987;316:844–52.PubMedCrossRefGoogle Scholar
  39. 39.
    Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW. American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines; American Association for Thoracic Surgery; American Society of Echocardiography; American Society of Nuclear Cardiology; Heart Failure Society of America; Heart Rhythm Society; Society for Cardiovascular Angiography and Interventions; Society of Thoracic Surgeons. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011;124:2761–96.PubMedCrossRefGoogle Scholar
  40. 40.
    van der Lee C, Scholzel B, ten Berg JM, et al. Usefulness of clinical, echocardiographic, and procedural characteristics to predict outcome after percutaneous transluminal septal myocardial ablation. Am J Cardiol. 2008;101:1315–20.PubMedCrossRefGoogle Scholar
  41. 41.
    Sherrid MV, Shetty A, Winson G, Kim B, Musat D, Alviar CL, Homel P, Balaram SK, Swistel DG. Treatment of obstructive hypertrophic cardiomyopathy symptoms and gradient resistant to first-line therapy with β-blockade or verapamil. Circ Heart Fail. 2013;6:694–702.PubMedCrossRefGoogle Scholar
  42. 42.
    Nishimura RA, Ommen SR. Hypertrophic cardiomyopathy: the search for obstruction. Circulation. 2006;114:2200–2.PubMedCrossRefGoogle Scholar
  43. 43.
    Wigle ED, Sasson Z, Henderson MA, Ruddy TD, Fulop J, Rakowski H, Williams WG. Hypertrophic cardiomyopathy: the importance of the site and the extent of hypertrophy: a review. Prog Cardiovasc Dis. 1985;28:1–83.PubMedCrossRefGoogle Scholar
  44. 44.
    Elesber A, Nishimura RA, Rihal CS, Ommen SR, Schaff HV, Holmes Jr DR. Utility of isoproterenol to provoke outflow tract gradients in patients with hypertrophic cardiomyopathy. Am J Cardiol. 2008;101:516–20.PubMedCrossRefGoogle Scholar
  45. 45.
    Baim DS. Grossman’s cardiac catheterization, angiography, and intervention. Philadelphia: Lippincott Williams & Wilkins; 2006.Google Scholar
  46. 46.
    Minakata K, Dearani JA, Nishimura RA, Maron BJ, Danielson GK. Extended septal myectomy for hypertrophic obstructive cardiomyopathy with anomalous mitral papillary muscles or chordae. J Thorac Cardiovasc Surg. 2004;127:481–9.PubMedCrossRefGoogle Scholar
  47. 47.
    Klues HG, Roberts WC, Maron BJ. Anomalous insertion of papillary muscle directly into anterior mitral leaflet in hypertrophic cardiomyopathy: significance in producing left ventricular outflow obstruction. Circulation. 1991;84:1188–97.PubMedCrossRefGoogle Scholar
  48. 48.
    Klues HG, Maron BJ, Dollar AL, Roberts WC. Diversity of structural mitral valve alterations in hypertrophic cardiomyopathy. Circulation. 1992;85:1651–60.PubMedCrossRefGoogle Scholar
  49. 49.
    Grigg LE, Wigle ED, Williams WG, et al. Transesophageal Doppler echocardiography in obstructive hypertrophic cardiomyopathy: clarification of pathophysiology and importance in intraoperative decision making. J Am Coll Cardiol. 1992;20:42–52.PubMedCrossRefGoogle Scholar
  50. 50.
    Maron MS, Lesser JR, Maron BJ. Management implications of massive left ventricular hypertrophy in hypertrophic cardiomyopathy significantly underestimated by echocardiography but identified by cardiovascular magnetic resonance. Am J Cardiol. 2010;105:1842–3.PubMedCrossRefGoogle Scholar
  51. 51.
    Rickers C, Wilke NM, Jerosch-Herold M, et al. Utility of cardiac magnetic resonance imaging in the diagnosis of hypertrophic cardiomyopathy. Circulation. 2005;112:855–61.PubMedCrossRefGoogle Scholar
  52. 52.
    Brugada P, Bär FW, de Zwaan C, Roy D, Green M, Wellens HJ. “Sawfish” systolic narrowing of the left anterior descending coronary artery: an angiographic sign of hypertrophic cardiomyopathy. Circulation. 1982;66:800–3.PubMedCrossRefGoogle Scholar
  53. 53.
    Maron BJ. Controversies in cardiovascular medicine. Surgical myectomy remains the primary treatment option for severely symptomatic patients with obstructive hypertrophic cardiomyopathy. Circulation. 2007;116:196–206.PubMedCrossRefGoogle Scholar
  54. 54.
    Schoendube FA, Klues HG, Reith S, et al. Long-term clinical and echocardiographic follow-up after surgical correction of hypertrophic obstructive cardiomyopathy with extended myectomy and reconstruction of the subvalvular mitral apparatus. Circulation. 1995;92 suppl 9:II122–7.PubMedCrossRefGoogle Scholar
  55. 55.
    Morrow AG, Brockenbrough EC. Surgical treatment of idiopathic hypertrophic subaortic stenosis: technic and hemodynamic results of subaortic ventriculomyotomy. Ann Surg. 1961;154:181–9.PubMedCentralPubMedCrossRefGoogle Scholar
  56. 56.
    McIntosh CL, Maron BJ, Cannon RO, Klues HG. Initial results of combined anterior mitral leaflet plication and ventricular septal myotomy-myectomy for relief of left ventricular outflow tract obstruction in patients with hypertrophic cardiomyopathy. Circulation. 1992;86:II60–7.PubMedGoogle Scholar
  57. 57.
    Kofflard MJ, van Herwerden LA, Waldstein DJ, Ruygrok P, Boersma E, Taams MA, ten Cate FJ. Initial results of combined anterior mitral leaflet extension and myectomy in patients with obstructive hypertrophic cardiomyopathy. J Am Coll Cardiol. 1996;28:197–202.PubMedCrossRefGoogle Scholar
  58. 58.
    Singh M, Edwards WD, Holmes Jr DR, Tajik AJ, Nishimura RA. Anatomy of the first septal perforating artery: a study with implications for ablation therapy for hypertrophic cardiomyopathy. Mayo Clin Proc. 2001;76:799–802.PubMedCrossRefGoogle Scholar
  59. 59.
    Olivotto I, Ommen SR, Maron MS, Cecchi F, Maron BJ. Surgical myectomy versus alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Will there ever be a randomized trial? J Am Coll Cardiol. 2007;50:831–4.PubMedCrossRefGoogle Scholar
  60. 60.
    Nagueh SF, Ommen SR, Lakkis NM, Killip D, Zoghbi WA, Schaff HV, Danielson GK, Quinones MA, Tajik AJ, Spencer WH. Comparison of ethanol septal reduction therapy with surgical myectomy for the treatment of hypertrophic obstructive cardiomyopathy. J Am Coll Cardiol. 2001;38:1701–6.PubMedCrossRefGoogle Scholar
  61. 61.
    Qin JX, Shiota T, Lever HM, Kapadia SR, Sitges M, Rubin DN, Bauer F, Greenberg NL, Agler DA, Drinko JK, Martin M, Tuzcu EM, Smedira NG, Lytle B, Thomas JD. Outcome of patients with hypertrophic obstructive cardiomyopathy after percutaneous transluminal septal myocardial ablation and septal myectomy surgery. J Am Coll Cardiol. 2001;38:1994–2000.PubMedCrossRefGoogle Scholar
  62. 62.
    Firoozi S, Elliott PM, Sharma S, Murday A, Brecker SJ, Hamid MS, Sachdev B, Thaman R, McKenna WJ. Septal myotomy-myectomy and transcoronary septal alcohol ablation in hypertrophic obstructive cardiomyopathy. A comparison of clinical, haemodynamic and exercise outcomes. Eur Heart J. 2002;23:1617–24.PubMedCrossRefGoogle Scholar
  63. 63.
    Ralph-Edwards A, Woo A, McCrindle BW, Shapero JL, Schwartz L, Rakowski H, Wigle ED, Williams WG. Hypertrophic obstructive cardiomyopathy: comparison of outcomes after myectomy or alcohol ablation adjusted by propensity score. J Thorac Cardiovasc Surg. 2005;129:351–8.PubMedCrossRefGoogle Scholar
  64. 64.
    Ten Cate FJ, Soliman OII, Michels M, Theuns DAMJ, de Jong PL, Geleijnse ML, Serruys PW. Long-term outcome of alcohol septal ablation in patients with obstructive hypertrophic cardiomyopathy. A word of caution. Circ Heart Fail. 2010;3:362–9.PubMedCrossRefGoogle Scholar
  65. 65.
    Sorajja P, Valeti U, Nishimura RA, Ommen SR, Rihal CS, Gersh BJ, Hodge DO, Schaff HV, Holmes Jr DR. Outcome of alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Circulation. 2008;118:131–9.PubMedCrossRefGoogle Scholar
  66. 66.
    Nagueh SF, Groves BM, Schwartz L, Smith KM, Wang A, Bach RG, Nielsen C, Leya F, Buergler JM, Rowe SK, Woo A, Maldonado YM, Spencer 3rd WH. Alcohol septal ablation for the treatment of hypertrophic obstructive cardiomyopathy. A multicenter North American registry. J Am Coll Cardiol. 2011;58:2322–8.PubMedCrossRefGoogle Scholar
  67. 67.
    Veselka J, Krejci J, Tomasov P, Zemanek D. Long-term survival after alcohol septal ablation for hypertrophic obstructive cardiomyopathy: a comparison with general population. Eur Heart J 2014; Jan 24. [Epub ahead of print].Google Scholar
  68. 68.
    Sorajja P, Binder J, Nishimura RA, Holmes Jr DR, Rihal CS, Gersh BJ, Bresnahan JF, Ommen SR. Predictors of an optimal clinical outcome with alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Catheter Cardiovasc Interv. 2013;81:E58–67.PubMedCrossRefGoogle Scholar
  69. 69.
    Agarwal S, Tuzcu EM, Desai MY, Smedira N, Lever HM, Lytle BW, Kapadia SR. Updated meta-analysis of septal alcohol ablation versus myectomy for hypertrophic cardiomyopathy. J Am Coll Cardiol. 2010;55:823–34.PubMedCrossRefGoogle Scholar
  70. 70.
    Alam M, Dokainish H, Lakkis NM. Hypertrophic obstructive cardiomyopathy-alcohol septal ablation vs. myectomy: a meta-analysis. Eur Heart J. 2009;30:1080–7.PubMedCrossRefGoogle Scholar
  71. 71.
    Leonardi RA, Kransdorf EP, Simel DL, Wang A. Meta-analyses of septal reduction therapies for obstructive hypertrophic cardiomyopathy: comparative rates of overall mortality and sudden cardiac death after treatment. Circ Cardiovasc Interv. 2010;3:97–104.PubMedCrossRefGoogle Scholar
  72. 72.
    McLeod CJ, Ommen SR, Ackerman MJ, et al. Surgical septal myectomy decreases the risk for appropriate implantable cardioverter defibrillator discharge in obstructive hypertrophic cardiomyopathy. Eur Heart J. 2007;28:2583–8.PubMedCrossRefGoogle Scholar
  73. 73.
    Ball W, Ivanov J, Rakowski H, et al. Long-term survival in patients with resting obstructive hypertrophic cardiomyopathy comparison of conser- vative versus invasive treatment. J Am Coll Cardiol. 2011;58:2313–21.PubMedCrossRefGoogle Scholar
  74. 74.
    Naidu SS. Survival and Pacemaker Risk After Alcohol Septal Ablation: Informing the Choice of Invasive Therapy for Hypertrophic Cardiomyopathy. Can J Cardiol. 2013 Jul 23. doi:pii: S0828-282X(13)00301-2.Google Scholar
  75. 75.
    Fernandes VL, Nagueh SF, Wang W, Roberts R, Spencer 3rd WH. A prospective follow-up of alcohol septal ablation for symptomatic hypertrophic obstructive cardiomyopathy — the Baylor experience (1996–2002). Clin Cardiol. 2005;28(3):124–30.PubMedCrossRefGoogle Scholar
  76. 76.
    Veselka J, Lawrenz T, Stellbrink C, Zemanek D, Branny M, Januska J, Groch L, Dimitrow P, Krejci J, Dabrowski M, Mizera S, Kuhn H. Low Incidence of Procedure-Related Major Adverse Cardiac Events After Alcohol Septal Ablation for Symptomatic Hypertrophic Obstructive Cardiomyopathy. Can J Cardiol. 2013 Aug 6. pii: S0828-282X(13)00263-8.Google Scholar
  77. 77.
    Maron BJ, Spirito P, Shen WK, Haas TS, Formisano F, Link MS, Epstein AE, Almquist AK, Daubert JP, Lawrenz T, Boriani G, Estes III NAM, Favale S, Piccininno M, Winters SL, Santini M, Betocchi S, Arribas F, Sherrid MV, Buja G, Semsarian C, Bruzzi P. Implantable cardioverter-defibrillators and prevention of sudden cardiac death in hypertrophic cardiomyopathy. JAMA. 2007;298:405–12.PubMedGoogle Scholar
  78. 78.
    Maron BJ, Yacoub M, Dearani JA. Benefits of surgery in obstructive hypertrophic cardiomyopathy: bring septal myectomy back for European patients. Eur Heart J. 2011;32:1055–8.PubMedCrossRefGoogle Scholar
  79. 79.
    Noseworthy PA, Rosenberg MA, Fifer MA, Palacios IF, Lowry PA, Ruskin JN, Sanborn DM, Picard MH, Vlahakes GJ, Mela T, Das S. Ventricular arrhythmia following alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Am J Cardiol. 2009;104:128–32.PubMedCrossRefGoogle Scholar
  80. 80.
    Kovacic JC, Khanna D, Kaplish D, et al. Safety and efficacy of alcohol septal ablation in patients with symptomatic concentric left ventricular hypertrophy and outflow tract obstruction. J Invasive Cardiol. 2010;22:586–91.PubMedGoogle Scholar
  81. 81.
    Naidu SS. Invasive thoughts: honoring two decades of alcohol septal ablation for hypertrophic cardiomyopathy. J Invasive Cardiol. 2013;25:369–70.PubMedGoogle Scholar
  82. 82.
    Gross CM, Schulz-Menger J, Kramer J, Siegel I, Pilz B, Waigand J, Friedrich MG, Uhlich F, Dietz R. Percutaneous transluminal septal artery ablation using polyvinyl alcohol foam particles for septal hypertrophy in patients with hypertrophic obstructive cardiomyopathy: acute and 3-year outcomes. J Endovasc Ther. 2004;11:705–11.PubMedCrossRefGoogle Scholar
  83. 83.
    Llamas-Esperon GA, Sandoval-Navarrete S. Percutaneous septal ablation with absorbable gelatin sponge in hypertrophic obstructive cardiomyopathy. Catheter Cardiovasc Interv. 2007;69:231–5.PubMedCrossRefGoogle Scholar
  84. 84.
    Lafont A, Durand E, Brasselet C, Mousseaux E, Hagege A, Desnos M. Percutaneous transluminal septal coil embolisation as an alternative to alcohol septal ablation for hypertrophic obstructive cardiomyopathy. Heart. 2005;91:92.PubMedCentralPubMedCrossRefGoogle Scholar
  85. 85.
    Durand E, Mousseaux E, Coste P, Pilliere R, Dubourg O, Trinquart L, Chatellier G, Hagege A, Desnos M, Lafont A. Non-surgical septal myocardial reduction by coil embolization for hypertrophic obstructive.Google Scholar
  86. 86.
    Lawrenz T, Kuhn H. Endocardial radiofrequency ablation of septal hypertrophy. A new catheter-based modality of gradient reduction in hypertrophic obstructive cardiomyopathy. Z Kardiol. 2004;93:493–9.PubMedCrossRefGoogle Scholar
  87. 87.
    Keane D, Hynes B, King G, Shiels P, Brown A. Feasibility study of percutaneous transvalvular endomyocardial cryoablation for the treatment of hypertrophic obstructive cardiomyopathy. J Invasive Cardiol. 2007;19:247–51.PubMedGoogle Scholar

Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  • Dmitriy N. Feldman
    • 1
  • John S. DouglasJr.
    • 2
  • Srihari S. Naidu
    • 3
    • 4
  1. 1.Greenberg Division of Cardiology, Department of MedicineWeill Cornell Medical College, New York Presbyterian HospitalNew YorkUSA
  2. 2.Andreas Gruentzig Cardiovascular CenterEmory University Hospital, Emory University School of MedicineAtlantaUSA
  3. 3.Hypertrophic Cardiomyopathy Treatment CenterWinthrop University HospitalMineolaUSA
  4. 4.SUNY Stony Brook School of MedicineStony BrookNew YorkUSA

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