Results of the alcohol septal ablation in combination with simultaneous endoprosthesis of coronary arteries in treatment of patients, suffering obstructive hypertrophic cardiomyopathy and concurrent ischemic heart disease

Abstract

Objective. To study the immediate and remote follow-up results of treatment in patients, suffering obstructive hypertrophic cardiomyopathy and concurrent ischemic heart disease, using the alcohol septal ablation in combination with simultaneous endoprosthesis of coronary arteries. Materials and methods. In the investigation were included 129 patients, suffering obstructive hypertrophic cardiomyopathy, to whom the alcohol septal ablation was performed in 2009 - 2018 yrs in M. M. Amosov National Institute of Cardiovascular Surgery. All the patients were distributed into two groups: the first -14 (10.9%) patients with concurrent ischemic heart disease and the second -115 (89.1%) patients without concurrent ischemic heart disease. Results. Reduction of the systolic pressure gradient in the exit tract of the left ventriculus, mitral regurgitation, and the functional class characteristic in accordance to criteria of a New-York Association of Cardiologists in both groups in immediate and late periods of observation have appeared statistically proved. In a remote period of follow-up in 13 (92.9%) patients, suffering the ischemic heart disease, a satisfactory hemodynamical result was registered, and in 1 (7.1%) - poor. Conditionally poor results in this group of patients were absent. The patients without an ischemic heart disease (n=107) in accordance to the above mentioned indices were distributed in a follow manner: 74 (69.2%), 28 (26.2%) and 5 (4.7%), accordingly. Statistically significant difference in accordance to hemodynamical results between two groups of patients was absent in immediate and remote periods of follow-up. Conclusion. Simultaneous conduction of the alcohol septal ablation in combination with endoprosthesis of coronary arteries in patients, suffering obstructive hypertrophic cardiomyopathy and concurrent ischemic heart disease, constitutes a safe proved combined intervention procedure, which owes good immediate results, persisting in the remote period.

Keywords

• hypertrophic cardiomyopathy; gradient of systolic pressure; the alcohol septal ablation; endoprosthesis of coronary arteries