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European Journal of Echocardiography 2004 5(6):443-448; doi:10.1016/j.euje.2004.04.003
© 2004 by European Society of Cardiology
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Copyright © 2004, The European Society of Cardiology

Quantitative analysis of intraprocedural myocardial contrast echocardiography during percutaneous septal ablation for hypertrophic obstructive cardiomyopathy

Detlef Hering*, Dirk Welge, Dieter Fassbender, Dieter Horstkotte and Lothar Faber

Department of Cardiology, Heart Center North Rhine-Westphalia, Ruhr University, Georgstrasse 11, 32545 Bad Oeynhausen, Germany

Received 8 October 2003; received in revised form 31 March 2004; accepted after revision 2 April 2004.

* Corresponding author. Tel.: +49-5731-971258; fax: +49-5731-972194. akohlstaedt{at}hdz-nrw.de


  Abstract

Aims: We tested whether procedural success of percutaneous septal ablation for hypertrophic obstructive cardiomyopathy is related to quantitative measurements of intraprocedural myocardial contrast echocardiography.

Methods and results: In a study group of 34 patients, the mean area of the contrast depot was 8.5 ± 2.5 cm2, its length along the left ventricular endocardial border 3.0 ± 0.7 cm and its proximal edge 2.0 ± 0.6 cm upstream the point of mitral–septal contact. Clinical and hemodynamic success was achieved in all but one patient 3 months following percutaneous septal ablation. The proximal edge of the ablation lesion correlated weakly (r = 0.5) with the proximal edge of the contrast depot with respect to their distance from the mitral valve leaflet tips. No other correlations were found between the efficacy of percutaneous septal ablation and various quantitative measurements of intraprocedural contrast echocardiography.

Conclusions: The localization of the ablation lesion 3 months after percutaneous septal ablation is predicted by the localization of the contrast depot with respect to the point of mitral–septal contact. The final hemodynamic effect of the ablation lesion, however, does not correlate with quantitative parameters of intraprocedural contrast echocardiography, but appears to be the result of an individual remodeling process.

Keywords: Percutaneous septal ablation; Intraprocedural myocardial contrast echocardiography; Hypertrophic obstructive cardiomyopathy

{star} Presented at EUROECHO 7, 3–6 December 2003, Barcelona, Spain.


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