Vol. 29 No. 3 (2025): Patologiya krovoobrashcheniya i kardiokhirurgiya
Endovascular Surgery

Predictors of procedural failure of alcohol septal ablation in patients with hypertrophic obstructive cardiomyopathy: data from a single-center retrospective study

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  • Aleksey A. Baranov,
  • Aram G. Badoyan,
  • Dmitrii A. Khelimskii,
  • Aryuna Yu. Tsydenova,
  • Mamur A. Makhmudov,
  • Nikita E. Pil,
  • Aleksey G. Kuchumov,
  • Oleg V. Krestyaninov
Aleksey A. Baranov
Meshalkin National Medical Research Center, Ministry of Health of the Russian Federation
Aram G. Badoyan
Meshalkin National Medical Research Center
Dmitrii A. Khelimskii
Meshalkin National Medical Research Center
Aryuna Yu. Tsydenova
Meshalkin National Medical Research Center
Mamur A. Makhmudov
Meshalkin National Medical Research Center, Novosibirsk
Nikita E. Pil
Research Center for Genetics and Life Sciences, Sirius University, Sirius Federal Territory
Aleksey G. Kuchumov
Laboratory of Biofluids, Perm National Research Polytechnic University
Oleg V. Krestyaninov
Meshalkin National Medical Research Center, Novosibirsk
DOI: https://doi.org/10.21688/1681-3472-2025-3-28-34

Published 2025-12-18

Keywords

  • гипертрофическая обструктивная кардиомиопатия; выходной тракт левого желудочка; градиент давления; спиртовая септальная абляция; процедурный неуспех

How to Cite

Baranov, A. A., Badoyan, A. G., Khelimskii, D. A., Tsydenova, A. Y., Makhmudov, M. A., Pil, N. E., Kuchumov, A. G., & Krestyaninov, O. V. (2025). Predictors of procedural failure of alcohol septal ablation in patients with hypertrophic obstructive cardiomyopathy: data from a single-center retrospective study. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 29(3), 28–34. https://doi.org/10.21688/1681-3472-2025-3-28-34

Copyright (c) 2025 Алексей Алексеевич Баранов, Арам Гозоевич Бадоян, Дмитрий Александрович Хелимский, Арюна Юрьевна Цыденова, Мамуржон Али Угли Maхмудов , Никита Евгеньевич Пиль, Алексей Геннадьевич Кучумов, Олег Викторович Крестьянинов

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Background: Comparative studies demonstrate commensurate longterm survival rates after surgical myectomy and alcohol septal ablation in patients with hypertrophic obstructive cardiomyopathy, although endovascular interventions are associated with a less pronounced decrease in the obstruction gradient and an increased rate of repeat procedures. Considering the proven interrelations between residual pressure gradient and long-term survival, identification of factors affecting the hemodynamic efficacy of alcohol septal ablation is of particular clinical importance for improving selection criteria for patient and optimizing therapeutic оutcomes.

Objective: The study was aimed at assessment of short-term results of
alcohol septal ablation and the detection of predictors for procedural failure of the intervention.

Methods: This retrospective single-center study included 71 patients with hypertrophic obstructive cardiomyopathy who underwent septal
alcohol ablation. The criterion for procedural failure of the intervention was considered to be the retention of the residual pressure gradient in the left
ventricular outflow tract of ≥30 mm Hg at rest and/or the provoked gradient
of ≥50 mm Hg at the time of patient discharge. The primary endpoint was
predictors of technical failure. Secondary endpoints included technical failure, in-hospital complications, and echocardiographic parameters.

Results: The rate of procedural failure was 26.8 % (19/71). In the postoperative period, a significant decrease in the pressure gradient in the left ventricular outflow tract was from 77 mm Hg (64, 95) to 27 mm Hg (19, 45) (p < 0.001). There were no cases of acute cerebrovascular accident and hospital mortality. Implantation of a permanent pacemaker was required in 4.3 % of cases. Independent predictors of procedural failure of alcohol septal ablation included initial values of left ventricular endsystolic volume (OR 1.08, 95 % CI 1.02–1.16, p = 0.023) and left ventricular end-diastolic volume (OR 1.10, 95 % CI 1.04–1.19, p = 0.019), as well as left ventricular posterior wall thickness (OR 1.40, 95 % CI 1.06–1.96, p = 0.030).

Conclusion: This study presents the experience of alcohol septal ablation
in a single center. Procedural success of the intervention was significantly
associated with initial left ventricular end-systolic volume, initial left
ventricular end-diastolic volume, and left ventricular posterior wall thickness

pdf (Русский)

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