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Alcohol Septal Ablation Treatment of Hypertrophic Obstructive Cardiomyopathy
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Patients with HOCM (Hypertrophic Obstructive Cardiomyopathy) who fail to respond to medical treatment with beta-blockers, calcium-channel antagonists, and/or disopyramide can now be effectively treated with Alcohol Septal Ablation (ASA) at the University of Colorado Denver. In HOCM, symptoms are produced by a bulge of heart muscle beneath the aortic valve that produces obstruction to outflow of blood from the left ventricle into the aorta. This non-surgical procedure is performed in the cardiac catheterization laboratory under local anesthesia. Absolute alcohol is selectively injected through a catheter in a septal artery that supplies the obstructive muscle and produces a targeted “therapeutic heart attack” that relieves the obstruction and associated symptoms. Since the beginning of this program in January 2002, 95 patients have been referred to the UCD from throughout the Rocky Mountain Region for potential ASA therapy. Forty-five patients were selected for treatment with ASA at the University of Colorado Hospital (UCH) or the Denver Veterans Administration Medical Center. These patients would have required open-heart surgery to surgically remove the obstructive muscle in the past. Our UCD clinical outcomes compare favorably with published outcomes and complications as follows: 1) all patients have had significant symptomatic improvement; 2) as expected, four (9%) developed complete heart block requiring permanent transvenous pacemaker implantation; 3) two patients required electrical cardioversion for episodes of ventricular fibrillation; and 4) there were no deaths associated with the procedure. The average UCH length of stay post procedure was 1.6 days.
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Bertron Groves, MD
Professor of Medicine
John Messenger, MD
Associate Professor of Medicine
Ivan Casserly,MD
Assistant Professor of Medicine
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Cathy Kenny, RN, ANP
Instructor, Nurse Practioner
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