The role of echocardiography in percutaneous transluminal septal myocardial ablation for obstructive hypertrophic cardiomyopathy

Abstract

Echocardiography is an integral part of characterizing patients with hypertrophic cardiomyopathy and helps procedural guidance for percutaneous transluminal septal myocardial ablation (PTSMA). Preprocedural echocardiography is useful in determining whether surgical septal myocardial resection or PTSMA is preferable for the treatment of septal reduction, based on the presence or absence of mitral valve complex abnormalities or repairable concomitant cardiac disease. Intraprocedural echocardiography provides essential information on the suitability of the targeted coronary septal branch for ablation and expected reduction in the pressure gradient after ablation. After the procedure, the pressure gradient in the middle of the left ventricle and near the apex may become prominent, necessitating evaluation of these stenoses. Appropriate use of echocardiography enables better patient selection for PTSMA and helps achieve the optimal procedure and follow-up strategies.