Focused Endocardial Septal Ablation: A New Technique to Treat Postmyectomy Recurrent Gradient.

Valdigem, Bruno Pereira; Correia, Edileide Barros; Ribeiro Moreira, Dalmo Antonio; Costa de Souza Le Bihan, David; Pinto Filho, Ibraim Masciarelli; Paladino Filho, Antonio Tito; Cunha Abizaid, Alexandre Antonio; Zucco Viesi, Joao Henrique et al. · Ann Thorac Surg · 2021

case_report · Level V

Where this comes from

Abstract

This report describes the case of a 64-year-old woman with a previous diagnosis of obstructive hypertrophic cardiomyopathy who underwent surgical myectomy but who had a persistent midventricular residual gradient. The patient was symptomatic despite medical treatment and chose to undergo percutaneous radiofrequency (RF) ablation focused on the gradient. RF delivery was performed, and the gradient was reduced from the initial 105/68 mm Hg (during Valsalva maneuver/at rest before ablation) to 24/10 mm Hg. This reduction was sustained for the next 12 months. Percutaneous RF ablation may be a reasonable option for second surgical myectomy, and the protocol can be easily reproduced.

Medical subject headings