Effectiveness and Safety Beyond 10 Years of Percutaneous Transluminal Septal Ablation in Hypertrophic Obstructive Cardiomyopathy
| Autor: | Manel Sabaté Tenas, Angel Sanchez Recalde, Federico Gimeno de Carlos, José M. de la Torre Hernández, Diego Fernandez Rodriguez, Piedad Lerena Saenz, Pablo Piñón Esteban, Javier Zueco Gil, Monica Masotti Centol, Marta Sitges Carreño |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Percutaneous Sudden death Septal Ablation Internal medicine medicine Humans Endocarditis Angioplasty Balloon Coronary Aged Ultrasonography Mitral regurgitation business.industry Hypertrophic cardiomyopathy General Medicine Cardiomyopathy Hypertrophic Middle Aged medicine.disease Surgery Cardiac surgery Treatment Outcome Heart failure Catheter Ablation Cardiology Female business Follow-Up Studies |
| Zdroj: | Revista Española de Cardiología (English Edition). 67:353-358 |
| ISSN: | 1885-5857 |
| Popis: | Percutaneous transluminal septal ablation is an alternative treatment in patients with hypertrophic obstructive cardiomyopathy. However, due to the relatively new introduction of this technique, there is no information on its very long term results (10 years).The present study included consecutive patients treated in 5 centers between 1998 and 2003. We analyzed clinical, hemodynamic, and echocardiographic data at baseline and follow-up.A total of 45 patients were included; there were 31 (69%) women, the mean age was 62.4 (14) years, and 39 patients (86.6%) showed functional class III or IV. Septal thickness was 21.8 (3.5) mm, the peak resting gradient on echocardiography was 77 (39) mmHg, and mitral regurgitation was at least moderate in 22 patients (48.8%). During hospitalization, permanent pacemaker implantation was required in 3 patients and ventricular perforation (by pacing lead) occurred in 1 patient, requiring surgery. After a follow-up of 12.3 years (11.0-13.5 years), 2 patients (4.4%) died from cardiac causes (heart failure and posttransplantation), 3 patients required an implantable cardioverter-defibrillator (1 for primary prevention and 2 due to sustained ventricular tachycardia after cardiac surgery), and 2 underwent cardiac surgery (due to endocarditis and mitral regurgitation). In the last clinical review, functional class was I-II in 39 patients (86.6%) (P.0001), the peak resting gradient was 16 (23) mmHg (P.0001), and mitral regurgitation was absent or mild in 34 patients (75.5%) (P.03).The results of this study suggest that septal ablation is safe and effective in the very long term. The procedure was not associated with a significant incidence of sudden death or symptomatic ventricular arrhythmias. |
| Databáze: | OpenAIRE |
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