Review Article

Percutaneous Septal Ablation in Hypertrophic Obstructive Cardiomyopathy: From Experiment to Standard of Care

Figure 6

Echocardiographic aspect of HOCM before/after a myectomy ((a)–(d)) and after a percutaneous septal ablation ((e)–(h)). Both cases show marked thickening of the midcavity and subaortic septum (arrows in (a) and (e)) at baseline together with a substantial outflow acceleration to >5 m/s corresponding to an outflow gradient of 100 mm Hg at rest ((b) and (f)). After the respective intervention there is thinning of the subaortic septum (arrows in (c) and (g)) and normalisation of LV outflow to <2 m/s, that is, absence of a resting gradient. The different ECG patterns of QRS widening with a LBBB pattern in C/D after myectomy and a RBBB pattern after septal ablation are also visible. LA: left atrium; RA: right atrium; RV: right ventricle; and LV: left ventricle.
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(a)
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(b)
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(c)
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(d)
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(e)
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(f)
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(g)
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(h)