Occlusion of the Septal Artery in Patients with Hypertrophic Obstructive Cardiomyopathy: Early and Midterm Results

A nonsurgical technique to achieve a reduction in septal mass by producing septal infaretion using balloon catheter techniques has been described. We have treated 13 patients by this novel technique and are presenting the results of the procedure in this first series of patients in terın s of the early and midterm period. Between November 1997 and May 13 patients had ev idence of HOCM by echocardiography and symptoms of angina and dyspnea despite optimal medical treatment (Class III). The mean age of the pat ients was 55 ± 12 years. The m ean resting gradient in L VOT decreased from 42 ± 15 mmHg to 9 ± 7 mmHg. M ean follow-up was 10.5 months. SPECT, done 5 to 7 day s after the procedure showed that the mean septal perfusion defect size involved 6.2 ± 2.6 o/o of the left ventricle. The mean septal thickness decreased from 2.6 ± 0.4 mm to 1.9 ± 0.5 ının at one ın on th. Functional class iınproved in all the patients (eleven were in Class I, two in Class II). A coınplete AV block occurred in two patients, which ınade iınplantation of perınanent paceınaker necessary. Induced se ptal infaretion produces signif icant hemodynaınic iınprovement during mediuın-terın follow-up, and is associated with considerable improve ın e nt in sy ınptoıns and quality of life. Since the long-terın effects of these procedures are unknown, patients with severe symptoms should be candidates.