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Percutaneous transluminal septal myocardial ablation (PTSMA) for symptomatic patients with hypertrophic obstructive cardiomyopathy: first experience.

BACKGROUND
Recently, percutaneous transluminal septal myocardial ablation (PTSMA) has been introduced as treatment for symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM).


METHODS
We describe our first experience in 24 patients who were treated in our institution during the year 2000.


RESULTS
The procedure was initially successful in all but one patient. In that patient the septal branch that was perfusing the proximal septum could not be found. The procedure was complicated in three patients. One patient died suddenly on the second day after the procedure. Two additional patients needed a permanent pacemaker for persisting total heart block. In the other 22 patients the procedure was successful with an acute decrease of the mean outflow tract gradient from 89±43 mmHg to 21±19 mmHg. In those 19 patients who had a follow-up of at least three months (mean follow-up 172±87 days), the mean NYHA class decreased from 2.7±0.7 before PTSMA to 0.6±0.9 at the last follow-up. The echocardiographic gradient decreased from 92±39 mmHg before the procedure to 26±23 mmHg at the last follow-up.


CONCLUSIONS
Our preliminary results demonstrate that PTSMA is an effective treatment for symptomatic patients with HOCM.