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gradient of 50 mmHg, which rose to 70 mmHg on provocation and to 125 mmHg on exercise, associated frequently with near-syncope. Because of the NYHA III functional status and the repeated syncopal attacks, persisting despite of optimal pharmacologic therapy, PTSMA was performed. During PTSMA selective and sub-selective angiography and contrast echocardiography was performed which did not reveal evident abnormal collateral connections. However, the alcohol, injected during ablation, may have propagated to the distal part of the right coronary artery, through functional abnormal collaterals, causing unwanted partial vessel closure and myocardial necrosis. Short and mid-term follow up indicated that hemodynamic results of PTSMA was excellent with no relevant clinical outcomes regarding the distal right coronary partial occlusion. lected on appropriate criteria for the procedure. The rigorous assessment of potential abnormal collateral connections bet-

Részleges epikardiális koronária-okklúzió perkután transzkoronáriás septalis myocardium abláció (PTSMA) során