Alcohol Septal Ablation: A useful tool in our arsenal against
hypertrophic obstructive cardiomyopathy
Abstract
Objective Affecting 1 in 500 individuals; Hypertrophic cardiomyopathy
(HCM) is an autosomal dominant cardiovascular disorder which is
prevalent throughout the world. Surgical myectomy and alcohol septal
ablation (ASA) are two methods currently used for the management of drug
refractory Hypertrophic obstructive cardiomyopathy (HOCM). ASA may prove
to be a useful, less invasive tool when confronting patients with HOCM
especially those who are more elderly or deemed to be a higher surgical
risk. Methods Electronic literature search was conducted to identify
relevant articles that discussed invasive methods to treat drug
refractory HOCM. No limits were placed on timing of the publication or
the type of article. Key words and MeSH terms were used to conduct the
search and the results were summarized in the relevant section. Results
Current evidence suggests that alcohol septal ablation is a safe and
effective procedure in treating patients with HOCM with similar short-
and long-term outcomes when compared with surgical myectomy. Selection
of patient with appropriate assessment is the key for satisfactory
outcomes. Conclusion ASA has been shown to be a safe and reliable
procedure; advanced imaging techniques and dedicated multi-disciplinary
teams can be used to carefully select patients with HOCM. Though
surgical myectomy is recommended as gold standard treatment for drug
refractory HOCM, however, ASA may play an increasing role in the near
future due an ageing population; both ASA and SM can have a synergistic
effect in treating those who are affected by HOCM.