de Hemptinne Quentin, Picard Fabien, L'Allier Philippe L
Interventional Cardiology Department, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street, Montreal, Québec H1T 1C8, Canada.
Cardiovasc Diagn Ther. 2017 Feb;7(1):92-97. doi: 10.21037/cdt.2016.08.01.
Alcohol septal ablation (ASA) is an effective semi-invasive alternative to surgical myectomy in selected patients for the management of severely symptomatic and drug-refractory hypertrophic obstructive cardiomyopathy (HOCM). One contraindication of this procedure is the presence of collateral flow originating from the target septal perforator to a remote myocardial territory. In such circumstances, ethanol injection could cause remote non-target myocardial necrosis in the collateralized territory. Percutaneous revascularization of the collateralized vessel prior to ASA might cope with this contraindication by restoring normal antegrade flow in the occluded artery. We report a case that illustrates the feasibility and efficacy of such strategy.
酒精间隔消融术（ASA）是一种有效的半侵入性方法，可替代手术性心肌切除术，用于特定患者严重症状性和药物难治性肥厚性梗阻性心肌病（HOCM）的治疗。该手术的一个禁忌症是存在从目标间隔穿支到远处心肌区域的侧支血流。在这种情况下，乙醇注射可能会导致侧支循环区域的远处非靶心肌坏死。在ASA之前对侧支血管进行经皮血管重建可能通过恢复闭塞动脉的正常顺行血流来应对这一禁忌症。我们报告了一个病例，说明了这种策略的可行性和有效性。
