BACKGROUND: Percutaneous transluminal septal myocardial ablation (PTSMA) recently emerged as an alternative to myectomy for hypertrophic obstructive cardiomyopathy (HOCM) patients with drug-refractory symptoms. The target septal branch selection is a main point to achieve the therapeutic result. METHODS AND RESULTS: We report about PTSMA performed using intracardiac echocardiography (ICE) to guide the procedure in 9 symptomatic HOCM patients. The target septal branch was chosen on the basis of the risk-area visualized using ICE after injection of a contrast agent. During alcohol administration a backscattered signal enhancement of the infarcted area was detected. The procedures were uncomplicated and effective to reduce the gradient from 78.9 ± 20.4 mmHg to 7.8 ± 8.9 mmHg (p < 0.0001). CONCLUSIONS: In this initial experience ICE monitoring during PTSMA was safe and provided high quality and continuous imaging of the treated segment of the septum during the whole procedure.

, , ,,
International Journal of Cardiovascular Interventions
Department of Cardiology

Pedone, C, Vijayakumar, M, Ligthart, J.M.R, Valgimigli, M, Biagini, E, de Jong, N, … ten Cate, F.J. (2005). Intracardiac echocardiography guidance during percutaneous transluminal septal myocardial ablation in patients with obstructive hypertrophic cardiomyopathy. International Journal of Cardiovascular Interventions, 7(3), 134–137. doi:10.1080/14628840500280575