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Background: The current guidelines favor surgical myectomy for treatment of young patients with medically refractory hypertrophic cardiomyopathy (HCM). The purpose of this study is to evaluate the safety, efficacy, and long-term outcomes of alcohol septal ablation (ASA) in HCM patients less than 40 years of age.
Methods: We analyzed 24 consecutive HCM patients less than 40 years of age (mean age: 34 years, age range 20-40 years, men 46%) treated with alcohol septal ablation at a high volume referral center (>300 ASA) from 1999 to 2014. All-cause mortality was verified against the U.S. Social Security Death Index.
Results: Mean septal thickness was 2.1 + 0.5 cm and posterior wall thickness was 1.3 + 0.4 cm by echocardiography prior to ASA. 1.3 + 0.5 septal perforators were injected with 2.9 + 1.1 mL of ethanol per patient. Mean resting gradient of 61 + 33 mm Hg was reduced to 8.6 + 10 mm Hg and mean provoked gradient of 85 + 19 mm Hg was reduced to 21 + 18 mm Hg after ASA. 5% (1/21 patients) required pacemaker placement with 3 patients having devices prior to ASA. Survival status was evaluated 8.7 + 3.7 years after ASA. There were no deaths during the study period. Survival after ASA at 1, 5, and 10 years was 100%.
Conclusions: ASA in young patients with HCM was safe and efficacious with excellent long-term survival at a single center with an experienced operator.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Structural Heart Interventions: Focus on Mitral Valve, Left Atrial Appendage and HOCM
Abstract Category: 19. Interventional Cardiology: Complex Patients/Comorbidities
Presentation Number: 1156-181
- 2017 American College of Cardiology Foundation