Obstructive hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy: the left ventricle is hypertrophic and has an obstruction at its exit to the aorta.
Alcohol septal ablation
Injection of ethanol into the septal artery to induce a localized infarction and relieve the obstruction to the aortic outflow tract.
What is septal ablation?
Alcohol septal ablation is a technique aimed at treating obstructive hypertrophic cardiomyopathy. This procedure is performed if the symptoms are too severe to be managed with medication. In obstructive hypertrophic cardiomyopathy, there is a thickening of the septum (the wall) that separates the ventricles of the heart, which eventually obstructs general blood flow. Alcohol septal ablation induces a very small controlled heart attack in the area where the heart tissue is abnormally thick. During alcohol septal ablation, the damaged tissues are destroyed and replaced by thinner scar tissue, allowing normal blood flow to be restored from the heart.
How is an ablation procedure performed?
A local anesthetic is injected at the catheter insertion site. The patient is also given a blood thinner and a sedative, if necessary. A contrast agent is also given to help doctors guide the catheter inside the body using real-time X-rays and echocardiography.
A thin catheter (tube) with a balloon at the end is inserted into a blood vessel in the groin and then guided to the heart using imaging techniques.
When the catheter reaches the blocked artery, the balloon is inflated to stop blood flow.
A small amount of pure alcohol is then injected through the catheter into the artery to destroy excess tissue blocking circulation. The patient may feel some discomfort or mild chest pain during this part of the procedure.
A few minutes later, the balloon and catheter are removed.
The patient then remains under observation in the hospital for a few days. Afterwards, he must limit his activities for a few months, until complete recovery.
Follow-up visits are scheduled to assess healing and heart function.
What are the risks of septal ablation?
Despite technical progress in catheters, balloons, and the experience of doctors, percutaneous septal ablation, like any invasive or surgical procedure, carries a risk of incidents or accidents.
Complications such as heart attack, serious heart rhythm disorders, stroke or coronary perforation are very rare. Exceptionally, emergency heart surgery may be necessary. Death is very rare.
Puncture site complications - These have become rare. The most common complication is a hematoma that can persist for several days, but is usually harmless. More rarely, an artery may become blocked or injured and require surgical repair and/or a blood transfusion.
Allergic complications - These are exceptional. Most often linked to iodinated contrast products or anesthetic products. If you have already had allergic manifestations, it is absolutely necessary to inform the doctor.
Conductive risk - the septal region to be ablated is close to the conduction pathways of the heart and the risk of a high degree conduction disorder requiring the implantation of a pacemaker is not negligible and is 10%.
Obstructive hypertrophic cardiomyopathy
Alcohol septal ablation
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