Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy

Hypertrophic obstructive cardiomyopathy (HOCM) is a cardiovascular disorder in which abnormal thickening of a particular portion of myocardium (usually proximal interventricular septum) results in obstruction or resistance to blood flow below the level of aortic valve. It is the leading cause of sudden cardiac death in athletes. Surgical myectomy has traditionally been the mainstay of treatment for patients with symptomatic HOCM despite maximal medical therapy. Catheter based therapy comprising of localized alcohol induced septal branch ablation was introduced as a possible alternative to surgical myectomy and is now being performed worldwide. New exploratory indications include its performance in very high risk subset with highly eccentric, thick septal anatomy before transcatheter aortic or mitral valve replacement, and as a last resort in ventricular tachycardia ablation procedures from foci not amenable to radiofrequency.

References

Maron BJ , Olivotto I , Spirito P , et al . Epidemiology of hypertrophic cardiomyopathy-related death: revisited in a large non-referral-based patient population . Circulation 2000 ; 102 : 858 – 864 .
10.1161/01.CIR.102.8.858
CAS PubMed Web of Science® Google Scholar
Maron MS , Olivotto I , Betocchi S , et al . Effect of left ventricular outflow tract obstruction on clinical outcome in hypertrophic cardiomyopathy . N Engl J Med 2003 ; 348 : 295 – 303 .
10.1056/NEJMoa021332
PubMed Web of Science® Google Scholar
Maron BJ , Bonow RO , Cannon RO III , et al . Hypertrophic cardiomyopathy. Interrelations of clinical manifestations, pathophysiology, and therapy . N Engl J Med 1987 ; 316 : 780 – 789 .
10.1056/NEJM198703263161305
CAS PubMed Web of Science® Google Scholar
Maron BJ . Hypertrophic cardiomyopathy: a systematic review . JAMA 2002 . 287 : 1308 – 1320 .
10.1001/jama.287.10.1308
PubMed Web of Science® Google Scholar
Gersh B.J. , Maron B.J. , Bonow R.O. , et al . ( 2011 ) 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy . J Am Coll Cardiol 58 : e212 – e260
10.1016/j.jacc.2011.06.011
CAS PubMed Web of Science® Google Scholar
Sigwart U. Non-surgical myocardial reduction for hypertrophic obstructive cardiomyopathy . The Lancet 1995 ; 346 : 211 – 214 .
10.1016/S0140-6736(95)91267-3
CAS PubMed Web of Science® Google Scholar
Brugada P , de Swart H , Smeets JL , et al . Transcoronary chemical ablation of ventricular tachycardia . Circulation 1989 ; 79 : 475 – 482 .
10.1161/01.CIR.79.3.475
CAS PubMed Web of Science® Google Scholar
Spencer WH III , Roberts R . Alcohol septal ablation in hypertrophicobstructive cardiomyopathy: the need for a registry . Circulation 2000 ; 102 : 600 – 601 .
10.1161/01.CIR.102.6.600
PubMed Web of Science® Google Scholar
Roberts R , Sigwart U . Current concepts of the pathogenesis and treatment of hypertrophic cardiomyopathy . Circulation 2005 ; 112 : 293 – 296 .
10.1161/01.CIR.0000146788.30724.0A
PubMed Web of Science® Google Scholar
Marron B . Controversies in cardiovascular medicine: surgical myectomy remains the primary treatment option for severely symptomatic patients with obstructive hypertrophic cardiomyopathy . Circulation 2007 ; 116 : 196 – 206 .
10.1161/CIRCULATIONAHA.107.691378
PubMed Web of Science® Google Scholar
Li ZQ , Cheng TO , Zhang WW , et al . Percutaneous transluminal septal myocardial ablation for hypertrophic obstructive cardiomyopathy: the Chinese experience in 119 patients from a single center . Int J Cardiol 2004 ; 93 : 197 – 202 .
10.1016/j.ijcard.2003.03.005
PubMed Web of Science® Google Scholar
Holmes DR Jr , Valeti US , Nishimura RA . Alcohol septal ablation for hypertrophic cardiomyopathy: indications and technique . Catheter Cardiovasc Interv 2005 ; 66 : 375 – 389 .
10.1002/ccd.20500
PubMed Web of Science® Google Scholar
Jiang L , Levine RA , King ME , et al . An integrated mechanism for systolic anterior motion of the mitral valve in hypertrophic cardiomyopathy based on echocardiographic observations . Am Heart J 1987 ; 113 : 633 – 644 .
10.1016/0002-8703(87)90701-0
CAS PubMed Web of Science® Google Scholar
Kuhn H , Gietzen FH , Schafers M , et al . Changes in the left ventricular outflow tract after transcoronary ablation of septal hypertrophy (TASH) for hypertrophic obstructive cardiomyopathy as assessed by transoesophageal echocardiography and by measuring myocardial glucose utilization and perfusion . Eur Heart J 1999 ; 20 : 1808 – 1817 .
10.1053/euhj.1999.1692
CAS PubMed Web of Science® Google Scholar
Lakkis NM , Nagueh SF , Kleiman NS , et al . Echocardiography-guided ethanol septal reduction for hypertrophic obstructive cardiomyopathy . Circulation 1998 ; 98 : 1750 – 1755 .
10.1161/01.CIR.98.17.1750
CAS PubMed Web of Science® Google Scholar
Nagueh SF , Lakkis NM , He ZX , et al . Role of myocardial contrast echocardiography during nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy . J Am Coll Cardiol 1998 ; 32 : 225 – 229 .
10.1016/S0735-1097(98)00220-4
CAS PubMed Web of Science® Google Scholar
van Dockum WG , ten Cate FJ , ten Berg JM , et al . Myocardial infarction after percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy: evaluation by contrast-enhanced magnetic resonance imaging . J Am Coll Cardiol 2004 ; 43 : 27 – 34 .
10.1016/j.jacc.2003.08.031
PubMed Web of Science® Google Scholar
Valeti US , Nishimura RA , Holmes DR Jr , et al . Comparison of surgical septal myectomy and alcohol septal ablation with cardiac magnetic resonance imaging in patients with hypertrophic obstructive cardiomyopathy . J Am Coll Cardiol 2007 ; 49 : 350 – 357 .
10.1016/j.jacc.2006.08.055
PubMed Web of Science® Google Scholar
Yoerger DM , Picard MH , Palacios IF , et al . Time course of pressure gradient response after first alcohol septal ablation for obstructive hypertrophic cardiomyopathy . Am J Cardiol 2006 ; 97 : 1511 – 1514 .
10.1016/j.amjcard.2005.12.040
PubMed Web of Science® Google Scholar
Flores-Ramirez R , Lakkis NM , Middleton KJ , et al . Echocardiographic insights into the mechanisms of relief of left ventricular outflow tract obstruction after nonsurgical septal reduction therapy in patients with hypertrophic obstructive cardiomyopathy . J Am Coll Cardiol 2001 ; 37 : 208 – 214 .
10.1016/S0735-1097(00)01045-7
CAS PubMed Web of Science® Google Scholar
Park TH , Lakkis NM , Middleton KJ , et al . Acute effect of nonsurgical septal reduction therapy on regional left ventricular asynchrony in patients with hypertrophic obstructive cardiomyopathy . Circulation 2002 ; 106 : 412 – 415 .
10.1161/01.CIR.0000025418.96995.ED
PubMed Web of Science® Google Scholar
Nagueh SF , Lakkis NM , Middleton KJ , et al . Changes in left ventricular diastolic function 6 months after nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy . Circulation 1999 ; 99 : 344 – 347 .
10.1161/01.CIR.99.3.344
CAS PubMed Web of Science® Google Scholar
Nagueh SF , Lakkis NM , Middleton KJ , et al . Changes in left ventricular filling and left atrial function six months after nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy . J Am Coll Cardiol 1999 ; 34 : 1123 – 1128 .
10.1016/S0735-1097(99)00341-1
CAS PubMed Web of Science® Google Scholar
Baggish AL , Smith RN , Palacios I , et al . Pathological effects of alcohol septal ablation for hypertrophic obstructive cardiomyopathy . Heart 2006 ; 92 : 1773 – 1778 .
10.1136/hrt.2006.092007
CAS PubMed Web of Science® Google Scholar
Mazur W , Nagueh SF , Lakkis NM , et al . Regression of left ventricular hypertrophy after nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy . Circulation 2001 ; 103 : 1492 – 1496 .
10.1161/01.CIR.103.11.1492
CAS PubMed Web of Science® Google Scholar
van Dockum WG , Beek AM , ten Cate FJ , et al . Early onset and progression of left ventricular remodeling after alcohol septal ablation in hypertrophic obstructive cardiomyopathy . Circulation 2005 ; 111 : 2503 – 2508 .
10.1161/01.CIR.0000165084.28065.01
PubMed Web of Science® Google Scholar
Henein MY , O'Sullivan CA , Ramzy IS , et al . Electromechanical left ventricular behavior after nonsurgical septal reduction in patients with hypertrophic obstructive cardiomyopathy . J Am Coll Cardiol 1999 ; 34 : 1117 – 1122 .
10.1016/S0735-1097(99)00332-0
CAS PubMed Web of Science® Google Scholar
Jassal DS , Neilan TG , Fifer MA , et al . Sustained improvement in left ventricular diastolic function after alcohol septal ablation for hypertrophic obstructive cardiomyopathy . Eur Heart J 2006 ; 27 : 1805 – 1810 .
10.1093/eurheartj/ehl106
PubMed Web of Science® Google Scholar
Sitges M , Shiota T , Lever HM , et al . Comparison of left ventricular diastolic function in obstructive hypertrophic cardiomyopathy in patients undergoing percutaneous septal alcohol ablation versus surgical myotomy/myectomy . Am J Cardiol 2003 ; 91 : 817 – 821 .
10.1016/S0002-9149(03)00016-X
PubMed Web of Science® Google Scholar
Boekstegers P , Steinbigler P , Molnar A , et al . Pressure-guided nonsurgical myocardial reduction induced by small septal infarctions in hypertrophic obstructive cardiomyopathy . J Am Coll Cardiol 2001 ; 38 : 846 – 853 .
10.1016/S0735-1097(01)01412-7
CAS PubMed Web of Science® Google Scholar
Nagueh SF , Stetson SJ , Lakkis NM , et al . Decreased expression of tumor necrosis factor-alpha and regression of hypertrophy after nonsurgical septal reduction therapy for patients with hypertrophic obstructive cardiomyopathy . Circulation 2001 ; 103 : 1844 – 1850 .
10.1161/01.CIR.103.14.1844
CAS PubMed Web of Science® Google Scholar
Faber L , Seggewiss H , Welge D , et al . Echo-guided percutaneous septal ablation for symptomatic hypertrophic obstructive cardiomyopathy: 7 years of experience . Eur J Echocardiography 2004 ; 5 : 347 – 355 .
10.1016/j.euje.2004.01.001
PubMed Google Scholar
Okayama H , Sumimoto T , Morioka N , et al . Usefulness of selective myocardial contrast echocardiography in percutaneous transluminal septal myocardial ablation: a case report . Jpn Circ J 2001 ; 65 : 842 – 844 .
10.1253/jcj.65.842
CAS PubMed Web of Science® Google Scholar
Harada T , Ohtaki E , Sumiyoshi T , et al . Papillary muscles identified by myocardial contrast echocardiography in preparation for percutaneous transluminal septal myocardial ablation . Acta Cardiol 2002 ; 57 : 25 – 27 .
10.2143/AC.57.1.2005377
PubMed Web of Science® Google Scholar
Li ZQ , Cheng TO , Liu L , et al . Experimental study of relationship between intracoronary alcohol injection and the size of resultant myocardial infarct . Int J Cardiol 2003 ; 91 : 93 – 96 .
10.1016/S0167-5273(02)00592-2
PubMed Web of Science® Google Scholar
Cheng TO . In percutaneous transluminal septal myocardial ablation for hypertrophic obstructive cardiomyopathy, it is not the speed of intracoronary alcohol injection but the amount of alcohol injected that determines the resultant infarct size . Circulation 2004 ; 110 : e23 .
10.1161/01.CIR.0000135537.69990.0F
PubMed Web of Science® Google Scholar
Veselka J , Prochazkova S , Duchonova R , et al . Alcohol septal ablation for hypertrophic obstructive cardiomyopathy: lower alcohol dose reduces size of infarction and has comparable hemodynamic and clinical outcome . Catheter Cardiovasc Interv 2004 ; 63 : 231 – 235 .
10.1002/ccd.20176
CAS PubMed Web of Science® Google Scholar
Watkins H , McKenna WJ . The prognostic impact of septal myectomy in obstructive hypertrophic cardiomyopathy . J Am Coll Cardiol 2005 ; 46 : 477 – 479 .
10.1016/j.jacc.2005.05.013
PubMed Web of Science® Google Scholar
Osman M , Kheiri B , Osman K , et al . Alcohol septal ablation vs myectomy for symptomatic hypertrophic obstructive cardiomyopathy: Systematic review and meta-analysis . Clin Cardiol. 2019 ; 42 ( 1 ): 190 – 197 . doi: 10.1002/clc.23113 .
10.1002/clc.23113
PubMed Web of Science® Google Scholar
Liebregts M , Faber L , Jensen MK , et al . Outcomes of Alcohol Septal Ablation in Younger Patients With Obstructive Hypertrophic Cardiomyopathy . JACC Cardiovasc Interv. 2017 ; 10 ( 11 ): 1134–1143 . doi: 10.1016/j.jcin.2017.03.030 .
10.1016/j.jcin.2017.03.030
PubMed Google Scholar
Firoozi S , Elliott PM , Sharma S , et al . Septal myotomy–myectomy and transcoronary septal alcohol ablation in hypertrophic obstructive cardiomyopathy . Eur Heart J 2002 ; 23 : 1617 – 1624 .
10.1053/euhj.2002.3285
CAS PubMed Web of Science® Google Scholar
Alam M , Dokainish H , Lakkis N . Alcohol septal ablation for hypertrophic obstructive cardiomyopathy: a systematic review of published studies . J Interven Cardiol 2006 ; 19 : 319 – 327 .
10.1111/j.1540-8183.2006.00153.x
CAS PubMed Google Scholar
Chang SM , Lakkis NM , Franklin J , et al . Predictors of outcome after alcohol septal ablation therapy in patients with hypertrophic obstructive cardiomyopathy . Circulation 2004 ; 109 : 824 – 827 .
10.1161/01.CIR.0000117089.99918.5A
PubMed Web of Science® Google Scholar
Simon RDB , Crawford FA III , Spencer WH III , et al . Sustained ventricular tachycardia following alcohol septal ablation for hypertrophic obstructive cardiomyopathy . Pacing Clin Electrophysiol 2005 ; 28 : 1354 – 1356 .
10.1111/j.1540-8159.2005.00278.x
PubMed Web of Science® Google Scholar
Faber L , Seggewiss H , Gleichmann U . Percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy: results with respect to intraprocedural myocardial contrast echocardiography . Circulation 1998 ; 98 : 2415 – 2421 .
10.1161/01.CIR.98.22.2415
CAS PubMed Web of Science® Google Scholar
Reinhard W , Ten Cate FJ , Scholten M , et al . Permanent pacing for complete atrioventricular block after nonsurgical (alcohol) septal reduction in patients with obstructive hypertrophic cardiomyopathy . Am J Cardiol 2004 ; 93 : 1064 – 1066 .
10.1016/j.amjcard.2003.12.065
PubMed Web of Science® Google Scholar
Chen AA , Palacios IF , Mela T , et al . Acute predictors of subacute complete heart block after alcohol septal ablation for obstructive hypertrophic cardiomyopathy . Am J Cardiol 2006 ; 97 : 264 – 269 .
10.1016/j.amjcard.2005.08.032
PubMed Web of Science® Google Scholar
Faber L , Welge D , Fassbender D , et al . Percutaneous septal ablation for symptomatic hypertrophic obstructive cardiomyopathy: managing the risk of procedurerelated AV conduction disturbances . Int J Cardiol 2007 ; 119 : 163 – 167 .
10.1016/j.ijcard.2006.07.179
PubMed Web of Science® Google Scholar
Lawrenz T , Lieder F , Bartelsmeier M , et al . Predictors of complete heart block after transcoronary ablation of septal hypertrophy. Results of a prospective electrophysiological investigation in 172 patients with hypertrophic obstructive cardiomyopathy . J Am Coll Cardiol 2007 ; 49 : 2356 – 2363 .
10.1016/j.jacc.2007.02.056
PubMed Web of Science® Google Scholar
Wykrzykowska JJ , Kwaku K , Wylie J , et al . Delayed occurrence of unheralded phase IV complete heart block after ethanol septal ablation for symmetric hypertrophic obstructive cardiomyopathy . Pacing Clin Electrophysiol 2006 ; 29 : 674 – 678 .
10.1111/j.1540-8159.2006.00416.x
PubMed Web of Science® Google Scholar
Talreja DR , Nishimura RA , Edwards WD , et al . Alcohol septal ablation versus surgical septal myectomy: comparison of effects on atrioventricular conduction tissue . J Am Coll Cardiol 2004 ; 44 : 2329 – 2332 .
10.1016/j.jacc.2004.09.036
PubMed Web of Science® Google Scholar
McCann GP , Van Dockum WG , Beek AM , et al . Extent of myocardial infarction and reverse remodeling assessed by cardiac magnetic resonance in patients with and without right bundle branch block following alcohol septal ablation for obstructive hypertrophic cardiomyopathy . Am J Cardiol 2007 ; 99 : 563 – 567 .
10.1016/j.amjcard.2006.08.067
PubMed Web of Science® Google Scholar
Runquist LH , Nielsen CD , Killip D , et al . Electrocardiographic findings after alcohol septal ablation therapy for obstructive hypertrophic cardiomyopathy . Am J Cardiol 2002 ; 90 : 1020 – 1022 .
10.1016/S0002-9149(02)02693-0
PubMed Web of Science® Google Scholar
Valettas N , Rho R , Beshai J , et al . Alcohol septal ablation complicated by complete heart block and permanent pacemaker failure . Catheter Cardiovasc Interv 2003 ; 58 : 189 – 193 .
10.1002/ccd.10412
CAS PubMed Web of Science® Google Scholar
Maron BJ , Dearani JA , Ommen SR , et al . The case for surgery in obstructive hypertrophic cardiomyopathy . J Am Coll Cardiol 2004 ; 44 : 2044 – 2053 .
10.1016/j.jacc.2004.04.063
PubMed Web of Science® Google Scholar
Gietzen FH , Leuner CJ , Raute-Kreinsen U , et al . Acute and long-term results after transcoronary ablation of septal hypertrophy (TASH): catheter interventional treatment for hypertrophic obstructive cardiomyopathy . Eur Heart J 1999 20 : 1342 – 1354 .
10.1053/euhj.1999.1520
CAS PubMed Web of Science® Google Scholar
Lawrenz T , Obergassel L , Lieder F , et al . Transcoronary ablation of septal hypertrophy does not alter ICD intervention rates in high risk patients with hypertrophic obstructive cardiomyopathy . Pacing Clin Electrophysiol 2005 ; 28 : 295 – 300 .
10.1111/j.1540-8159.2005.09327.x
CAS PubMed Web of Science® Google Scholar
Pedone C , Vijayakumar M , Ligthart JM , et al . Intracardiac echocardiography guidance during percutaneous transluminal septal myocardial ablation in patients with obstructive hypertrophic cardiomyopathy . Int J Cardiovasc Intervent 2005 ; 7 : 134 – 137 .
10.1080/14628840500280575
PubMed Google Scholar
Alfonso F , Martín D , Fernández-Vázquez F , et al . Intracardiac echocardiography guidance for alcohol septal ablation in hypertrophic obstructive cardiomyopathy . J Invasive Cardiol 2007 ; 19 : E134 – E136 .
PubMed Google Scholar
Bach RG , Leach C , Milov SA , et al . Use of magnetic navigation to facilitate transcatheter alcohol septal ablation for hypertrophic obstructive cardiomyopathy . J Invasive Cardiol 2006 ; 18 : E176 – E178 .
PubMed Google Scholar
Gross CM , Schulz-Menger J , Kramer J , et al . Percutaneous transluminal septal artery ablation using polyvinyl alcohol foam particles for septal hypertrophy in patients with hypertrophic obstructive cardiomyopathy: acute and three-year outcomes . J Endovasc Ther 2004 ; 11 : 705 – 711 .
10.1583/03-1171MR.1
PubMed Web of Science® Google Scholar
Llamas-Espero GA , Sandoval-Navarrete S . Percutaneous septal ablation with absorbable gelatin sponge in hypertrophic obstructive cardiomyopathy . Catheter Cardiovasc Interv 2007 ; 69 : 231 – 235 .
10.1002/ccd.20935
PubMed Web of Science® Google Scholar
Durand E , Mousseaux E , Coste P , et al . Non-surgical septal myocardial reduction by coil embolization for hypertrophic obstructive cardiomyopathy: early and 6 months follow-up . Eur Heart J 2008 ; 29 : 348 – 355 .
10.1093/eurheartj/ehm632
PubMed Web of Science® Google Scholar
Lawrenz T , Kuhn H. Endocardial radiofrequency ablation of septal hypertrophy: a new catheter-based modality of gradient reduction in hypertrophic obstructive cardiomyopathy . Z Kardiol 2004 ; 93 : 493 – 499 .
10.1007/s00392-004-0097-x
CAS PubMed Web of Science® Google Scholar
Keane D , Hynes B , King G , et al . Feasibility study of percutaneous transvalvular endomyocardial cryoablation for the treatment of hypertrophic obstructive cardiomyopathy . J Invasive Cardiol 2007 ; 19 : 247 – 251 .
PubMed Google Scholar
Hess OM , Schneider J , Turina M , et al . Asymmetric septal hypertrophy in patients with aortic stenosis: an adaptive mechanism or a coexistence of hypertrophic cardiomyopathy? J Am Coll Cardiol 1983 ; 1 : 783 – 9 .
10.1016/S0735-1097(83)80191-0
CAS PubMed Web of Science® Google Scholar
Krishnaswamy A , Tuzcu EM , Svensson LG , Kapadia SR . Combined transcatheter aortic valve replacement and emergent alcohol septal ablation . Circulation 2013 ; 128 : e366 – e368 .
10.1161/CIRCULATIONAHA.112.000470
PubMed Web of Science® Google Scholar
Asaad A. Khan , Gilbert H.L . Tang , Krysthel Engstrom , et al . Aortic Stenosis With Severe Asymmetric Septal Hypertrophy . J Am Coll Cardiol Intv. 2019 Nov, 12 ( 21 ) 2228 – 2230 .
10.1016/j.jcin.2019.06.025
Google Scholar
Wang DD , Guerrero M , Eng MH , et al . Alcohol Septal Ablation to Prevent Left Ventricular Outflow Tract Obstruction During Transcatheter Mitral Valve Replacement: First-in-Man Study . JACC Cardiovasc Interv . 2019 ; 12 : 1268 – 1279
10.1016/j.jcin.2019.02.034
PubMed Web of Science® Google Scholar
Guandalini GS , Liang JJ , Marchlinski FE Ventricular Tachycardia Ablation: Past, Present, and Future Perspectives . JACC Clin Electrophysiol . 2019 ; 5 : 1363 – 1383
10.1016/j.jacep.2019.09.015
PubMed Google Scholar
Veselka J , Krejčí J , Tomašov P , Zemánek D . Long-term survival after alcohol septal ablation for hypertrophic obstructive cardiomyopathy: a comparison with general population . Eur Heart J 2014 ; 35 ( 30 ): 2040 – 2045 .
10.1093/eurheartj/eht495
PubMed Web of Science® Google Scholar
Maron BJ , Maron MS . Hypertrophic cardiomyopathy . The Lancet 2013 ; 381 ( 9862 ): 242 – 245 .
10.1016/S0140-6736(12)60397-3
PubMed Web of Science® Google Scholar
Almasood A , Garceau P , Woo A , et al . Time to significant gradient reduction following septal balloon occlusion predicts the magnitude of final gradient response during alcohol septal ablation in patients with hypertrophic obstructive cardiomyopathy . JACC Cardiovasc Interv 2011 ; 4 ( 9 ): 1030 – 1034 .
10.1016/j.jcin.2011.06.008
PubMed Web of Science® Google Scholar
Quintana E , Sabate-Rotes A , Maleszewski JJ , et al . Septal myectomy after failed alcohol ablation: does previous percutaneous intervention compromise outcomes of myectomy? J Thorac Cardiovasc Surg 2015 ; 150 ( 1 ): 159 – 216 .
10.1016/j.jtcvs.2015.03.044
PubMed Web of Science® Google Scholar
Maron BJ , Nishimura RA . Surgical septal myectomy versus alcohol septal ablation: assessing the status of the controversy in 2014 . Circulation 2014 ; 130 ( 18 ): 1617 – 1624 .
10.1161/CIRCULATIONAHA.114.011580
PubMed Web of Science® Google Scholar
Sigwart U . Therapeutic Myocardial Infarction for Hypertrophic Obstructive Cardiomyopathy: Is It Appropriate? Circulation 2019 ; 140 ( 1 ): 11 – 12 .
10.1161/CIRCULATIONAHA.119.039889
PubMed Google Scholar

Interventional Cardiology: Principles and Practice, Third Edition