Intravenous myocardial contrast echocardiography can predict recurrence of pressure gradient of left ventricular outflow tract in hypertrophic obstructive cardiomyopathy after percutaneous transluminal septal myocardial ablation

Abstract

Percutaneous transluminal septal myocardial ablation (PTSMA) is appropriate in patients who are refractory to medical treatments for hypertrophic obstructive cardiomyopathy (HOCM). However, about 10% of patients show recurrence of left ventricular outflow tract pressure gradient (LVOG) after PTSMA and need repeat PTSMA. The authors describe two HOCM cases who underwent intravenous myocardial contrast echocardiography (IVMCE) at two weeks after PTSMA. IVMCE revealed the total defect of the PTSMA area in one patient, a 69-year-old woman. This patient has shown no recurrence of LVOG for 4 years. Faintly stained PTSMA area by IVMCE was seen in the other patient, an 83-year-old woman. This patient had a recurrence of LVOG 3 months later. Therefore, in conclusion, IVMCE might predict recurrence of LVOG after PTSMA.