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Wang H, Lei C, Liu L. A case report of percutaneous intramyocardial septal radiofrequency ablation in an adult with re-obstruction after Morrow procedure. Eur Heart J Case Rep 2024; 8:ytae145. [PMID: 38590297 PMCID: PMC11000820 DOI: 10.1093/ehjcr/ytae145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 04/10/2024]
Abstract
Background Some patients with hypertrophic cardiomyopathy (HCM) re-occur with drug-refractory symptoms but are not eligible for re-operation after the Morrow procedure. Traditional treatment options are limited. We present the first case of the use of ultrasound-guided percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) for the treatment of a patient with HCM combined with congenital anatomically corrected malposition of the great arteries (MGA) after Morrow procedure. Case summary A 61-year-old male patient with congenital MGA, who had been treated with the Morrow procedure for HCM, had worsening symptoms in recent years that were difficult to control medically. He was diagnosed with occult obstructive HCM by stress echocardiography. After multi-disciplinary discussion, this patient was treated with PIMSRA. The post-operative clinical outcome was remarkable, with a significant decrease in septal thickness and disappearance of the left anterior branch conduction block. Conclusion Percutaneous intramyocardial septal radiofrequency ablation is feasible and can be one of the options for the treatment of patients with HCM, especially those who cannot choose Morrow procedure. However, it still needs a large sample of clinical trials to validate its clinical effectiveness.
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Affiliation(s)
- Huiyi Wang
- Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Airforce Military Medical University, Xi’an, Shannxi 710032, China
| | - Changhui Lei
- Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Airforce Military Medical University, Xi’an, Shannxi 710032, China
| | - Liwen Liu
- Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Airforce Military Medical University, Xi’an, Shannxi 710032, China
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Lv X, Li J, Liu C, Wei R, Meng L, Kong X, Wei K, Cao G, Liu K. Single coronary ostium with obstructive hypertrophic cardiomyopathy treated using the Morrow procedure: a case report. J Cardiothorac Surg 2022; 17:340. [PMID: 36578088 PMCID: PMC9798688 DOI: 10.1186/s13019-022-02084-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 12/10/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Hypertrophic cardiomyopathy is a commonly inherited heart disease. In addition, single coronary artery (SCA) is a rare congenital anomaly of the coronary arteries. And SCA concomitant with severe hypertrophic obstructive cardiomyopathy (HOCM) has seldom been reported in the literature. However, such cases have not been reported to be treated with the Morrow procedure. CASE PRESENTATION Herein, we presented a case of a 64-year-old female diagnosed with a single left coronary artery with severe HOCM. The HOCM was treated with the Morrow procedure. The patient was discharged on the seventh postoperative day and was asymptomatic during the follow-up. CONCLUSION To our knowledge, this is the first study reporting a single left coronary artery with severe HOCM treated with the Morrow procedure. In addition, myocardial protection by cardioplegia antegrade perfusion was safe for the patient with SCA and HOCM.
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Affiliation(s)
- Xin Lv
- grid.452402.50000 0004 1808 3430Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, No.107, West Wenhua Road, Jinan, 250012 Shandong China
| | - Jianhua Li
- grid.452402.50000 0004 1808 3430Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, No.107, West Wenhua Road, Jinan, 250012 Shandong China
| | - Chuanzhen Liu
- grid.452402.50000 0004 1808 3430Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, No.107, West Wenhua Road, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Shandong University, Jinan, 250061 Shandong China ,Pantheum Biotechnology Co., Ltd, Shandong Jinan, China
| | - Ruyuan Wei
- grid.452402.50000 0004 1808 3430Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, No.107, West Wenhua Road, Jinan, 250012 Shandong China
| | - Lingwei Meng
- grid.452402.50000 0004 1808 3430Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, No.107, West Wenhua Road, Jinan, 250012 Shandong China
| | - Xiangjin Kong
- grid.452402.50000 0004 1808 3430Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, No.107, West Wenhua Road, Jinan, 250012 Shandong China
| | - Kaiming Wei
- grid.452402.50000 0004 1808 3430Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, No.107, West Wenhua Road, Jinan, 250012 Shandong China
| | - Guangqing Cao
- grid.452402.50000 0004 1808 3430Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, No.107, West Wenhua Road, Jinan, 250012 Shandong China
| | - Kai Liu
- grid.452402.50000 0004 1808 3430Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, No.107, West Wenhua Road, Jinan, 250012 Shandong China
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Rigopoulos AG, Sakellaropoulos S, Ali M, Mavrogeni S, Manginas A, Pauschinger M, Noutsias M. Transcatheter septal ablation in hypertrophic obstructive cardiomyopathy: a technical guide and review of published results. Heart Fail Rev 2019; 23:907-917. [PMID: 29736811 DOI: 10.1007/s10741-018-9706-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Transcatheter alcohol septal ablation (ASA) treatment of symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM) is based on the existence and degree of intraventricular obstruction. Patients with significant gradient and symptoms who do not respond to optimal medical therapy are eligible to gradient reduction through a surgical (septal myectomy) or a transcatheter (alcohol septal ablation) septal reduction. The latter encompasses occlusion of a septal branch perfusing the hypertrophied septum, which is involved in the generation of obstruction, by injecting ethanol into the supplying septal branch(es). ASA has been established as a highly effective and safe method and has outnumbered the surgical gold standard. Although the technique is straightforward, patient selection and some technical details may influence the efficacy and safety of the procedure. The technique is based on echocardiographic contrast guidance, which allows accurate target septal branch selection and optimisation of the result. Published long-term results from high-volume centres have confirmed the effectiveness of ASA and have shown excellent survival, which is comparable to that in the general population. Choice and performance of the surgical or interventional treatment should be implemented in highly specialised centres in terms of a heart-team approach, taking notice of anatomic characteristics as well as comorbidities. Involvement of all cases in international registries may reveal the individual merits and indications for the surgical and interventional treatment in HOCM.
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Affiliation(s)
- Angelos G Rigopoulos
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, D-06120, Halle, Germany.
| | - Stefanos Sakellaropoulos
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, D-06120, Halle, Germany
| | - Muhammad Ali
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, D-06120, Halle, Germany
| | - Sophie Mavrogeni
- Onassis Cardiac Surgery Center, 50 Esperou Street, 175-61, Palaeo Faliro, Athens, Greece
| | - Athanassios Manginas
- Interventional Cardiology and Cardiology Department, Mediterraneo Hospital, Ilias Street 8-12, 16675, Glyfada, Greece
| | - Matthias Pauschinger
- Department of Cardiology, Internal Medicine 8, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany
| | - Michel Noutsias
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, D-06120, Halle, Germany
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