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.

Contrast agent, Hypertrophic obstructive cardiomyopathy, Intracardiac echocardiography, Percutaneous transluminal myocardial septal ablation,
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