Alcohol septal ablation in hypertrophic obstructive cardiomyopathy

Hellenic Journal of Cardiology

Volumn 50, Issue 6, 2009, Pages 511-522

  Rigopoulos, Angelos G ^a   Panou, Fotios ^a   Kremastinos, Dimitrios Th ^a   Seggewiss, Hubert ^b  

^a UNIVERSITY OF ATHENS MEDICAL SCHOOL   (Greece)

^b Leopoldina Krankenhaus   (Germany)

Author keywords

Myocardial contrast echocardiography; Survival

Indexed keywords

ALCOHOL; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; DISOPYRAMIDE; VERAPAMIL;

ANGIOCARDIOGRAPHY; CATHETER ABLATION; HEART LEFT VENTRICLE OUTFLOW TRACT OBSTRUCTION; HEART VENTRICLE ARRHYTHMIA; HUMAN; HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY; MUSCLE RESECTION; MYOTOMY; PACEMAKER; PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY; PERCUTANEOUS TRANSLUMINAL SEPTAL MYOCARDIAL ABLATION; REVIEW;

ABLATION TECHNIQUES; CARDIOMYOPATHY, HYPERTROPHIC; CORONARY ANGIOGRAPHY; ECHOCARDIOGRAPHY; ETHANOL; HEART SEPTUM; HUMANS; INJECTIONS; RADIOGRAPHY, INTERVENTIONAL; ULTRASONOGRAPHY, INTERVENTIONAL;

EID: 73249145460     PISSN: 10117970     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (102)

1. Spirito P, Seidman CE, McKenna WJ, Maron BJ. The management of hypertrophic cardiomyopathy. N Engl J Med. 1997; 336: 775-785.
2. Wigle ED, Rakowski H, Kimball BP, Williams WG. Hypertrophic cardiomyopathy. Clinical spectrum and treatment. Circulation. 1995; 92: 1680-1692.
3. Rigopoulos A, Anastasakis A. Hypertrophic cardiomyopathy: recent aspects and knowledge of the last decade. Hellenic J Cardiol. 2000; 41: 212-234.
4. Georgakopoulos D, Tolis V. Hypertrophic cardiomyopathy in children, teenagers and young adults. Hellenic J Cardiol. 2007; 48: 228-233.
5. Maron BJ, McKenna WJ, Danielson GK, et al. American College of Cardiology/European Society of Cardiology clinical expert consensus document on hypertrophic cardiomyopathy. A report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents and the European Society of Cardiology Committee for Practice Guidelines. J Am Coll Cardiol. 2003; 42: 1687-1713.
6. Maron BJ. Hypertrophic cardiomyopathy: a systematic review. JAMA. 2002; 287: 1308-1320.
7. Wigle ED, Sasson Z, Henderson MA, et al. Hypertrophic cardiomyopathy. The importance of the site and the extent of hypertrophy. A review. Prog Cardiovasc Dis. ; 28: 1-83.
8. 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.
9. Maron BJ, Nishimura RA, Danielson GK. Pitfalls in clinical recognition and a novel operative approach for hypertrophic cardiomyopathy with severe outflow obstruction due to anomalous papillary muscle. Circulation. 1998; 98: 2505-2508.
10. Maron MS, Olivotto I, Zenovich AG, et al. Hypertrophic cardiomyopathy is predominantly a disease of left ventricular outflow tract obstruction. Circulation. 2006; 114: 2232-2239.
11. Shah JS, Esteban MTT, Thaman R, et al. Prevalence of exercise-induced left ventricular outflow tract obstruction in symptomatic patients with non-obstructive hypertrophic cardiomyopathy. Heart. 2008; 94: 1288-1294.
12. Fifer MA, Vlahakes GJ. Management of symptoms in hypertrophic cardiomyopathy. Circulation. 2008; 117: 429-439.
13. Frank MJ, Abdulla AM, Canedo MI, Saylors RE. Long-term medical management of hypertrophic obstructive cardiomyopathy. Am J Cardiol. 1978; 42: 993-1001.
14. Haberer T, Hess OM, Jenni R, Krayenbühl HP. [Hypertrophic obstructive cardiomyopathy: spontaneous course in comparison to long-term therapy with propranolol and verapamil]. Z Kardiol. 1983; 72: 487-493.
15. Harrison DC, Braunwald E, Glick G, Mason DT, Chidsey CA, Ross J. Effects of beta adrenergic blockade on the circulation with particular reference to observations in patients with hypertrophic subaortic stenosis. Circulation. 1964; 29: 84-98.
16. Kaltenbach M, Hopf R, Kober G, Bussmann WD, Keller M, Petersen Y. Treatment of hypertrophic obstructive cardiomyopathy with verapamil. Br Heart J. 1979; 42: 35-42.
17. Sherrid MV, Barac I, McKenna WJ, et al. Multicenter study of the efficacy and safety of disopyramide in obstructive hypertrophic cardiomyopathy. J Am Coll Cardiol. 2005; 45: 1251-1258.
18. Pollick C. Muscular subaortic stenosis: hemodynamic and clinical improvement after disopyramide. N Engl J Med. 1982; 307: 997-999.
19. Kimball BP, Bui S, Wigle ED. Acute dose-response effects of intravenous disopyramide in hypertrophic obstructive cardiomyopathy. Am Heart J. 1993; 125: 1691-1697.
20. Sherrid M, Delia E, Dwyer E. Oral disopyramide therapy for obstructive hypertrophic cardiomyopathy. Am J Cardiol. 1988; 62: 1085-1088.
21. Maron BJ. Appraisal of dual-chamber pacing therapy in hypertrophic cardiomyopathy: too soon for a rush to judgment? J Am Coll Cardiol. 1996; 27: 431-432.
22. Woo A, Williams WG, Choi R, et al. Clinical and echocardiographic determinants of long-term survival after surgical myectomy in obstructive hypertrophic cardiomyopathy. Circulation. 2005; 111: 2033-2041.
23. Schulte HD, Gramsch-Zabel H, Schwartzkopff B. [Hypertrophic obstructive cardiomyopathy: surgical treatment]. Schweiz Med Wochenschr. 1995; 125: 1940-1949.
24. Robbins RC, Stinson EB. Long-term results of left ventricular myotomy and myectomy for obstructive hypertrophic cardiomyopathy. J Thorac Cardiovasc Surg. 1996; 111: 586-594.
25. Heric B, Lytle BW, Miller DP, Rosenkranz ER, Lever HM, Cosgrove DM. Surgical management of hypertrophic obstructive cardiomyopathy. Early and late results. J Thorac Cardiovasc Surg. 1995; 110: 195-206; discussion 206-208.
26. Schoendube FA, Klues HG, Reith S, Flachskampf FA, Hanrath P, Messmer BJ. Long-term clinical and echocardiographic follow-up after surgical correction of hypertrophic obstructive cardiomyopathy with extended myectomy and reconstruction of the subvalvular mitral apparatus. Circulation. 1995; 92: II122-127.
27. Sigwart U. Non-surgical myocardial reduction for hypertrophic obstructive cardiomyopathy. Lancet. 1995; 346: 211-214.
28. Seggewiss H. Current status of alcohol septal ablation for patients with hypertrophic cardiomyopathy. Curr Cardiol Rep. 2001; 3: 160-166.
29. Kuhn H, Gietzen F, Leuner C, Gerenkamp T. Induction of subaortic septal ischaemia to reduce obstruction in hypertrophic obstructive cardiomyopathy. Studies to develop a new catheter-based concept of treatment. Eur Heart J. 1997; 18: 846-851.
30. Brugada P, de Swart H, Smeets JL, Wellens HJ. Transcoronary chemical ablation of ventricular tachycardia. Circulation. 1989; 79: 475-482.
31. Seggewiss H, Gleichmann U, Faber L, Fassbender D, Schmidt HK, Strick S. Percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy: acute results and 3-month follow-up in 25 patients. J Am Coll Cardiol. 1998; 31: 252-258.
32. 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.
33. Seggewiss H, Rigopoulos A, Faber L, Ziemssen P. Alcohol septal ablation. In: Maron BJ, editor. Diagnosis and management of hypertrophic cardiomyopathy. Malden, Mass.; Oxford: Blackwell Futura; 2004: p. 259-278.
34. Angelini P. The "1st septal unit" in hypertrophic obstructive cardiomyopathy: a newly recognized anatomo-functional entity, identified during recent alcohol septal ablation experience. Tex Heart Inst J. 2007; 34: 336-346.
35. Rigopoulos A, Sepp R, Palinkas A, Ungi I, Kremastinos DT, Seggewiss H. Alcohol septal ablation for hypertrophic obstructive cardiomyopathy: collateral vessel communication between septal branches. Int J Cardiol. 2006; 113: e67-69.
36. Singh M, Edwards WD, Holmes DR, Tajil AJ, Nishimura RA. Anatomy of the first septal perforating artery: a study with implications for ablation therapy for hypertrophic cardiomyopathy. Mayo Clin Proc. 2001; 76: 799-802.
37. Faber L, Seggewiss H, Fassbender D, et al. Guiding of percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy by myocardial contrast echocardiography. J Interv Cardiol. 1998; 11: 443-448.
38. Faber L, Seggewiss H, Welge D, et al. Echo-guided percutaneous septal ablation for symptomatic hypertrophic obstructive cardiomyopathy: 7 years of experience. Eur J Echocardiogr. 2004; 5: 347-355.
39. Kuhn H, Lawrenz T, Lieder F, et al. Survival after transcoronary ablation of septal hypertrophy in hypertrophic obstructive cardiomyopathy (TASH): a 10 year experience. Clin Res Cardiol. 2008; 97: 234-243.
40. Veselka J, Procházková S, Duchonová 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.
41. Veselka J, Duchonová R, Páleníckova J, et al. Impact of ethanol dosing on the long-term outcome of alcohol septal ablation for obstructive hypertrophic cardiomyopathy: a singlecenter prospective, and randomized study. Circ J. 2006; 70: 1550-1552.
42. Veselka J, Zemánek D, Tomasov P, Duchonová R, Linhartová K. Alcohol septal ablation for obstructive hypertrophic cardiomyopathy: ultra-low dose of alcohol (1 ml) is still effective. Heart Vessels. 2009; 24: 27-31.
43. Ruzyllo W, Chojnowska L, Demkow M, et al. Left ventricular outflow tract gradient decrease with non-surgical myocardial reduction improves exercise capacity in patients with hypertrophic obstructive cardiomyopathy. Eur Heart J. 2000; 21: 770-777.
44. 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.
45. Gietzen FH, Leuner CJ, Obergassel L, Strunk-Mueller C, Kuhn H. Transcoronary ablation of septal hypertrophy for hypertrophic obstructive cardiomyopathy: feasibility, clinical benefit, and short term results in elderly patients. Heart. 2004; 90: 638-644.
46. Lakkis NM, Nagueh SF, Kleiman NS, et al. Echocardiography-guided ethanol septal reduction for hypertrophic obstructive cardiomyopathy. Circulation. 1998; 98: 1750-1755.
47. 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.
48. Veselka J. Alcohol septal ablation for hypertrophic obstructive cardiomyopathy: a review of the literature. Med Sci Monit. 2007; 13: RA62-68.
49. Maron BJ, Casey SA, Poliac LC, Gohman TE, Almquist AK, Aeppli DM. Clinical course of hypertrophic cardiomyopathy in a regional United States cohort. JAMA. 1999; 281: 650-655.
50. Seggewiss H, Faber L. Percutaneous septal ablation for hypertrophic cardiomyopathy and mid-ventricular obstruction. Eur J Echocardiogr. 2000; 1: 277-280.
51. Faber L, Welge D, Hering D, et al. Percutaneous septal ablation after unsuccessful surgical myectomy for patients with hypertrophic obstructive cardiomyopathy. Clin Res Cardiol. 2008; 97: 899-904.
52. Seggewiss H, Faber L, Meyners W, Bogunovic N, Odenthal HJ, Gleichmann U. Simultaneous percutaneous treatment in hypertrophic obstructive cardiomyopathy and coronary artery disease: a case report. Cathet Cardiovasc Diagn. 1998; 44: 65-69.
53. Alfonso F, Isla LP, Seggewiss H. Contrast echocardiography during alcohol septal ablation: friend or foe? Heart. 2005; 91: e18.
54. Parham WA, Kern MJ. Apical infarct via septal collateralization complicating transluminal alcohol septal ablation for hypertrophic cardiomyopathy. Catheter Cardiovasc Interv. 2003; 60: 208-211.
55. Knight C, Kurbaan AS, Seggewiss H, et al. Nonsurgical septal reduction for hypertrophic obstructive cardiomyopathy: outcome in the first series of patients. Circulation. 1997; 95: 2075-2081.
56. Lakkis N, Kleiman N, Killip D, Spencer WH 3rd. Hypertrophic obstructive cardiomyopathy: alternative therapeutic options. Clin Cardiol. 1997; 20: 417-418.
57. Bhargava B, Agarwal R, Kaul U, Manchanda SC, Wasir HS. Transcatheter alcohol ablation of the septum in a patient of hypertrophic obstructive cardiomyopathy. Cathet Cardiovasc Diagn. 1997; 41: 56-58.
58. Kornacewicz-Jach Z, Gil R, Woltarowicz A, et al. Early results of alcohol ablation of the septal branch of coronary artery in patients with hypertrophic obstructive cardiomyopathy. Pol Heart J. 1998; 48: 105.
59. 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.
60. Seggewiss H, Faber L, Gleichmann U. Percutaneous transluminal septal ablation in hypertrophic obstructive cardiomyopathy. Thorac Cardiovasc Surg. 1999; 47: 94-100.
61. Faber L, Meissner A, Ziemssen P, Seggewiss H. Percutaneous transluminal septal myocardial ablation for hypertrophic obstructive cardiomyopathy: long term follow up of the first series of 25 patients. Heart. 2000; 83: 326-331.
62. Seggewiss H, Faber L, Ziemssen P, et al. Age related acute results in percutaneous septal ablation in hypertrophic obstructive cardiomyopathy. J Am Coll Cardiol. 2000; 35 (Suppl A): 188A (abstract).
63. Faber L, Welge D, Fassbender D, Schmidt HK, Horstkotte D, Seggewiss H. One-year follow-up of percutaneous septal ablation for symptomatic hypertrophic obstructive cardiomyopathy in 312 patients: predictors of hemodynamic and clinical response. Clin Res Cardiol. 2007; 96: 864-873.
64. Seggewiss H, Rigopoulos A, Welge D, Ziemssen P, Faber L. Long-term follow-up after percutaneous septal ablation in hypertrophic obstructive cardiomyopathy. Clin Res Cardiol. 2007; 96: 856-863.
65. Qin JX, Shiota T, Lever HM, et al. Outcome of patients with hypertrophic obstructive cardiomyopathy after percutaneous transluminal septal myocardial ablation and septal myectomy surgery. J Am Coll Cardiol. 2001; 38: 1994-2000.
66. Rivera S, Sitges M, Azqueta M, et al. [Left ventricular remodeling in patients with hypertrophic obstructive cardiomyopathy treated with percutaneous alcohol septal ablation: an echocardiographic study]. Rev Esp Cardiol. 2003; 56: 1174-1181.
67. Yoerger DM, Picard MH, Palacios IF, Vlahakes GJ, Lowry PA, Fifer MA. Time course of pressure gradient response after first alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Am J Cardiol. 2006; 97: 1511-1514.
68. 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.
69. Welge D, Seggewiss H, Fassbender D, Schmidt HK, Horstkotte D, Faber L. [Long-term follow-up after percutaneous septal ablation in hypertrophic obstructive cardiomyopathy]. Dtsch Med Wochenschr. 2008; 133: 1949-1954. German.
70. 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.
71. Curtius JM, Stoecker J, Loesse B, Welslau R, Scholz D. Changes of the degree of hypertrophy in hypertrophic obstructive cardiomyopathy under medical and surgical treatment. Cardiology. 1989; 76: 255-263.
72. Lakkis NM, Nagueh SF, Dunn JK, Killip D, Spencer WH 3rd. Nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy: one-year follow-up. J Am Coll Cardiol. 2000; 36: 852-855.
73. 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.
74. Soliman OII, Geleijnse ML, Michels M, et al. Effect of successful alcohol septal ablation on microvascular function in patients with obstructive hypertrophic cardiomyopathy. Am J Cardiol. 2008; 101: 1321-1327.
75. Pedone C, Biagini E, Galema TW, Vletter WB, ten Cate FJ. Myocardial perfusion after percutaneous transluminal septal myocardial ablation as assessed by myocardial contrast echocardiography in patients with hypertrophic obstructive cardiomyopathy. J Am Soc Echocardiogr. 2006; 19: 982-986.
76. Gietzen FH, Leuner CJ, Obergassel L, Strunk-Mueller C, Kuhn H. Role of transcoronary ablation of septal hypertrophy in patients with hypertrophic cardiomyopathy, New York Heart Association functional class III or IV, and outflow obstruction only under provocable conditions. Circulation. 2002; 106: 454-459.
77. Alam M, Dokainish H, Lakkis N. Alcohol septal ablation for hypertrophic obstructive cardiomyopathy: a systematic review of published studies. J Interv Cardiol. 2006; 19: 319-327.
78. Pauschinger M, Keren A. Increasing evidence for the safety and efficacy of alcohol septal ablation during medium- and long-term follow-up. Clin Res Cardiol. 2007; 96: 851-855.
79. Kern MJ, Holmes DG, Simpson C, Bitar SR, Rajjoub H. Delayed occurrence of complete heart block without warning after alcohol septal ablation for hypertrophic obstructive cardiomyopathy. Catheter Cardiovasc Interv. 2002; 56: 503-507.
80. Reinhard W, Ten Cate FJ, Scholten M, De Laat LE, Vos J. Permanent pacing for complete atrioventricular block after nonsurgical (alcohol) septal reduction in patients with obstructive hypertrophic cardiomyopathy. Am J Cardiol. 2004; 93: 1064-1066.
81. Faber L, Seggewiss H, Welge D, et al. [Predicting the risk of atrioventricular conduction lesions after percutaneous septal ablation for obstructive hypertrophic cardiomyopathy]. Z Kardiol. 2003; 92: 39-47. German.
82. Faber L, Welge D, Fassbender D, Schmidt HK, Horstkotte D, Seggewiss H. Percutaneous septal ablation for symptomatic hypertrophic obstructive cardiomyopathy: managing the risk of procedure-related AV conduction disturbances. Int J Cardiol. 2007; 119: 163-167.
83. Coakley E, Steinberg DH, Tibrewala A, et al. Effect of alcohol septal ablation in patients with hypertrophic cardiomyopathy on the electrocardiographic pattern. Am J Cardiol. 2008; 102: 621-624.
84. 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.
85. Williams WG, Wigle ED, Rakowski H, Smallhorn J, LeBlanc J, Trusler GA. Results of surgery for hypertrophic obstructive cardiomyopathy. Circulation. 1987; 76: V104-108.
86. 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.
87. Qin JX, Shiota T, Lever HM, et al. Conduction system abnormalities in patients with obstructive hypertrophic cardiomyopathy following septal reduction interventions. Am J Cardiol. 2004; 93: 171-175.
88. Faber L, Seggewiss H, Ziemssen P, Gleichmann U. Intraprocedural myocardial contrast echocardiography as a routine procedure in percutaneous transluminal septal myocardial ablation: detection of threatening myocardial necrosis distant from the septal target area. Catheter Cardiovasc Interv. 1999; 47: 462-466.
89. Mayer SA, Anwar A, Grayburn PA. Comparison of successful and failed alcohol septal ablations for obstructive hypertrophic cardiomyopathy. Am J Cardiol. 2003; 92: 241-242.
90. Efthimiadis GK, Spanos GP, Giannakoulas G, et al. Hypertrophic cardiomyopathy with late enhancement of the nonhypertrophied left ventricular segments. Hellenic J Cardiol. 2008; 49: 114-116.
91. Malek LA, Chojnowska L, Klopotowski M, et al. Long term exercise capacity in patients with hypertrophic cardiomyopathy treated with percutaneous transluminal septal myocardial ablation. Eur J Heart Fail. 2008; 10: 1123-1126.
92. Maron BJ, Dearani JA, Ommen SR, et al. The case for surgery in obstructive hypertrophic cardiomyopathy. J Am Coll Cardiol. 2004; 44: 2044-2053.
93. 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.
94. Seggewiss H, Faber L, Ziemssen P. Alcohol septal ablation for hypertrophic obstructive cardiomyopathy. Cardiol Rev. 1999; 7: 316-323.
95. Boltwood CM, Chien W, Ports T. Ventricular tachycardia complicating alcohol septal ablation. N Engl J Med. 2004; 351: 1914-1915.
96. Cuoco FA, Spencer WH 3rd, Fernandes VL, et al. Implantable cardioverter-defibrillator therapy for primary prevention of sudden death after alcohol septal ablation of hypertrophic cardiomyopathy. J Am Coll Cardiol. 2008; 52: 1718-1723.
97. Veselka J, Honek T. Early remodelling of left ventricle and improvement of myocardial performance in patients after percutaneous transluminal septal myocardial ablation for hypertrophic obstructive cardiomyopathy. Int J Cardiol. 2003; 88: 27-32.
98. Elliott PM, Gimeno JR, Tomé MT, et al. Left ventricular outflow tract obstruction and sudden death risk in patients with hypertrophic cardiomyopathy. Eur Heart J. 2006; 27: 1933-1941.
99. Raute-Kreinsen U. Morphology of necrosis and repair after transcoronary ethanol ablation of septal hypertrophy. Pathol Res Pract. 2003; 199: 121-127.
100. Olivotto I, Ommen SR, Maron MS, Cecchi F, Maron BJ. Surgical myectomy versus alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Will there ever be a randomized trial? J Am Coll Cardiol. 2007; 50: 831-834.
101. Nagueh SF, Ommen SR, Lakkis NM, et al. Comparison of ethanol septal reduction therapy with surgical myectomy for the treatment of hypertrophic obstructive cardiomyopathy. J Am Coll Cardiol. 2001; 38: 1701-1706.
102. Firoozi S, Elliott PM, Sharma S, et al. Septal myotomy-myectomy and transcoronary septal alcohol ablation in hypertrophic obstructive cardiomyopathy. A comparison of clinical, haemodynamic and exercise outcomes. Eur Heart J. 2002; 23: 1617-1624.