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Alcohol septal ablation after myomectomy failure solutions for unusual cases
Author(s) -
Cano Manuel Nicolas,
Fortunato de Cano Silvia Judith,
Sousa J. Eduardo M.R.
Publication year - 2010
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.22539
Subject(s) - medicine , alcohol septal ablation , ablation , surgery , cardiology , obstructive cardiomyopathy , hypertrophic cardiomyopathy
We report an eight‐year‐old child presented with classical features of Hypertrophic Obstructive Cardiomyopathy and with New York Heart Association (NYHA) class III symptoms, eight months after Myectomy and refractory to medical treatment. Cardiac transplantation was indicated due to the severity of symptoms. But the Lymphocyte Reaction Test showed almost 100% reaction of antibodies, and the surgeons rejected the heart transplantation for fear of hyperacute rejection. Then an Alcohol Septal Ablation (ASA) was proposed, which was successfully performed on August 17, 2005. The post‐extrasystolic gradient was reduced from 160 to 60 mm Hg immediately and no other complications were seen. The child is being followed since then and echocardiography changes include a further reduction of septum thickness and gradient ( P = 0.001), and important symptoms relieved after 3.5 years of follow up. ASA may be an option to be considered in children with critical Hypertrophic Obstructive Cardiomyopathy in NYHA functional class III/IV, when other methods of treatment failed. © 2010 Wiley‐Liss, Inc.