Long-term clinical efficacy and safety of coil embolization of the septal perforator in patients with hypertrophic obstructive cardiomyopathy
Objective:To evaluate the safety and long-term clinical efficacy of coil embolization of the septal perforator in patients with hypertrophic obstructive cardiomyopathy (HOCM).Methods:Data of three HOCM patients who received coil embolization of the septal perforator from June 2017 to June 2018 at Army Medical Center were retrospectively collected. The baseline characteristics, symptoms, left ventricular outflow tract gradient (LVOTG), and maximum interventricular septum thickness before and after the procedure were recorded for analysis.Results:All the patients complained of varying degrees of dyspnea and chest distress and the LVOTG was higher than 50 mmHg (1 mmHg=0.133 kPa) in all cases. The septal perforator was successfully embolized with coil and demonstrated by target artery angiography without the occurrence of high degree atrioventricular block. The LVOTG was significantly reduced after the procedure except case 1. The LVOTG of case 1 failed to improve and sudden death occurred 2 months after discharge. The symptoms of the other two cases were all relieved but during the long-term follow up, an increase in the LVOTG and maximum interventricular septum thickness was observed.Conclusion:The results of this pilot study suggest that coil embolization of the septal perforator is feasible and safe but long-term follow-up showed an increase in the LVOTG and maximum interventricular septum thickness to some extent.