{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T17:21:46Z","timestamp":1778001706294,"version":"3.51.4"},"reference-count":73,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T00:00:00Z","timestamp":1621209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Myocardial contrast two-dimensional echocardiography (MC-2DE) is widely used to address alcohol septal ablation (ASA) in obstructive hypertrophic cardiomyopathy (HCM). Owing to its limited cut-planes, MC-2DE may inaccurately identify the contrast misplacement associated with an unsuccessful or complicated ASA outcome. Objective: The aim of this study was to assess the added value of myocardial contrast three-dimensional echocardiography (MC-3DE) compared with MC-2DE to identify the appropriate matching between the target septal zone (TSZ) and coronary artery branch for safe and long-term effective ASA in HCM patients. Methods: A consecutive series of 52 symptomatic obstructive HCM patients referred for isolated surgical myectomy (SM) was analyzed with MC-2DE and MC-3DE following injection of echocontrast into one or more septal branches. MC-2DE and MC-3DE patterns were categorized according to complete (Type 1) or incomplete (Type 2) TSZ covering, high-risk (Type 3) exceeding TSZ, or life-threatening outside TSZ distribution (Type 4). Results: MC-2DE per patient analysis showed a Type 1 pattern in 32 patients and Types 2\u20134 in the remaining 20 patients; subsequent MC-3DE analysis provided a re-phenotyping of MC-2DE findings in 22 of the 52 patients (42%), showing a high-risk Type 2 pattern in 17 of the 32 patients with Type 1, and a new life-threatening Type 4 in three patients with Type 2, respectively. All patients with MC-3DE Type 1 pattern underwent safe and effective ASA with a long-term uneventful follow-up, while the remaining patients underwent SM. Conclusions: Refining high risk or life-threatening contrast misplacement, MC-3DE is more accurate than conventional MC-2DE to target safe and long-term effective septal reduction with ASA in obstructive HCM patients referred for isolated SM.<\/jats:p>","DOI":"10.3390\/jcm10102166","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T12:19:57Z","timestamp":1621253997000},"page":"2166","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Targeting Alcohol Septal Ablation in Patients with Obstructive Hypertrophic Cardiomyopathy Candidates for Surgical Myectomy: Added Value of Three-Dimensional Intracoronary Myocardial Contrast Echocardiography"],"prefix":"10.3390","volume":"10","author":[{"given":"Giovanni","family":"La Canna","sequence":"first","affiliation":[{"name":"Applied Diagnostic Echocardiography Unit, IRCCS Humanitas Clinical and Research Center, 20089 Rozzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iside","family":"Scarf\u00f2","sequence":"additional","affiliation":[{"name":"Applied Diagnostic Echocardiography Unit, IRCCS Humanitas Clinical and Research Center, 20089 Rozzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Arendar","sequence":"additional","affiliation":[{"name":"Applied Diagnostic Echocardiography Unit, IRCCS Humanitas Clinical and Research Center, 20089 Rozzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Colombo","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, IRCCS Humanitas Clinical and Research Center, 20089 Rozzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Torracca","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, IRCCS Humanitas Clinical and Research Center, 20089 Rozzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Margonato","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Montorfano","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ottavio","family":"Alfieri","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e007673","DOI":"10.1161\/CIRCINTERVENTIONS.118.007673","article-title":"Guideline-based referral for septal reduction therapy in obstructive hypertrophic cardiomyopathy is associated with excellent clinical outcomes","volume":"12","author":"Kimmelstiel","year":"2019","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1161\/CIRCRESAHA.116.309348","article-title":"Hypertrophic obstructive cardiomyopathy: Surgical myectomy and septal ablation","volume":"15","author":"Nishimura","year":"2017","journal-title":"Circ. Res."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Byty\u00e7i, S., Nistri, S., M\u00f6rner, S., and Henein, M.Y. (2020). Alcohol septal ablation versus septal myectomy treatment of obstructive Hypertrophic Cardiomyopathy: A systematic review and meta-analysis. J. Clin. Med., 9.","DOI":"10.3390\/jcm9103062"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3087","DOI":"10.1016\/j.jacc.2018.09.064","article-title":"Survival after alcohol septal ablation in patients with hypertrophic obstructive cardiomyopathy","volume":"72","author":"Batzner","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1093\/eurheartj\/ehv693","article-title":"Long-term clinical outcome after alcohol septal ablation for obstructive hypertrophic cardiomyopathy: Results from the Euro-ASA registry","volume":"37","author":"Veselka","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1161\/CIRCINTERVENTIONS.109.916676","article-title":"Meta-analyses of septal reduction therapies for obstructive hypertrophic cardiomyopathy","volume":"3","author":"Leonardi","year":"2010","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1016\/j.jchf.2015.06.011","article-title":"A systematic review and meta-analysis of long-term outcomes after septal reduction therapy in patients with hypertrophic cardiomyopathy","volume":"3","author":"Liebregts","year":"2015","journal-title":"JACC Hearth Fail."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/j.jcin.2015.11.036","article-title":"Long-term outcome of alcohol septal ablation for obstructive hypertrophic cardiomyopathy in the young and the elderly","volume":"14","author":"Liebregts","year":"2016","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/j.cjca.2014.03.041","article-title":"Survival of patients \u226450 years of age after alcohol septal ablation for hypertrophic obstructive cardiomyopathy","volume":"30","author":"Veselka","year":"2014","journal-title":"Can. J. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1016\/j.jcin.2017.03.030","article-title":"Outcomes of alcohol septal ablation in younger patients with obstructive hypertrophic cardiomyopathy","volume":"10","author":"Liebregts","year":"2017","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2415","DOI":"10.1161\/01.CIR.98.22.2415","article-title":"Percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy: Results with respect to intraprocedural myocardial contrast echocardiography","volume":"22","author":"Faber","year":"1998","journal-title":"Circulation"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1016\/j.amjcard.2004.08.030","article-title":"Usefulness of myocardial contrast echocardiographic quantification of risk area for predicting postprocedural complications in patients undergoing septal ethanol ablation for obstructive hypertrophic cardiomyopathy","volume":"94","author":"Monakier","year":"2004","journal-title":"Am. J. Cardiol."},{"key":"ref_13","first-page":"271","article-title":"Real-time myocardial contrast echo-cardiography for echo-guided alcohol septal ablation","volume":"5","author":"Veselka","year":"2009","journal-title":"Arch. Med. Sci."},{"key":"ref_14","first-page":"531","article-title":"Alcohol ablation in hypertrophic cardiomyopathy: Localization and quantification of target septal artery-dependent myocardium with 3-dimensional echocardiography","volume":"68","year":"2015","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"E197","DOI":"10.1111\/echo.12567","article-title":"Rapid Visualization of PTSMA target area by real time 3D myocardial contrast echocardiography","volume":"31","author":"Bogunovic","year":"2014","journal-title":"Echocardiography"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2733","DOI":"10.1093\/eurheartj\/ehu284","article-title":"2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: The Task Force for the diag-nosis and management of hypertrophic cardiomyopathy of the European Society of Cardiology (ESC)","volume":"35","author":"Elliott","year":"2014","journal-title":"Eur. Heart J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1688","DOI":"10.1016\/j.amjcard.2020.03.004","article-title":"Phenotyping left ventricular obstruction with postprandial re-test echocardiography in hypertrophic cardiomyopathy","volume":"125","author":"Arendar","year":"2020","journal-title":"Am. J. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1056\/NEJMoa021332","article-title":"Effect of left ventricular outflow tract obstruction on clinical outcome in hypertrophic cardiomyopathy","volume":"348","author":"Maron","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1093\/eurheartj\/ehl041","article-title":"Left ventricular outflow tract obstruction and sudden death risk in patients with hypertrophic cardiomyopathy","volume":"27","author":"Elliott","year":"2006","journal-title":"Eur. Heart J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1056\/NEJMra1710575","article-title":"Clinical Course and Management of Hypertrophic Cardiomyopathy","volume":"379","author":"Maron","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2313","DOI":"10.1016\/j.jacc.2011.08.040","article-title":"Long-term survival in patients with resting obstructive hypertrophic cardiomyopathy","volume":"58","author":"Ball","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3095","DOI":"10.1016\/j.jacc.2018.10.013","article-title":"Septal reduction therapy for hypertrophic obstructive cardiomyo-pathy","volume":"72","author":"Fifer","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_23","first-page":"e558","article-title":"2020 AHA\/ACC Guideline for the Diagnosis and Treatment of Patients with Hypertrophic Cardiomyopathy: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"142","author":"Ommen","year":"2020","journal-title":"Circulation"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"307","DOI":"10.21037\/acs.2017.06.04","article-title":"Current state of the art and future of myectomy","volume":"6","author":"Yacoub","year":"2017","journal-title":"Ann. Cardiothorac. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/j.pcad.2012.04.007","article-title":"Echocardiography to Individualize treatment for hypertrophic cardiomyopathy","volume":"54","author":"Sherrid","year":"2012","journal-title":"Progr. Cardiovasc. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1093\/ejcts\/ezx458","article-title":"Individualized surgical strategies for left ventricular outflow tract obstruction in hypertrophic cardiomyopathy","volume":"53","author":"Collis","year":"2018","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1038\/ncpcardio0988","article-title":"Alcohol septal ablation versus surgical myectomy: A patient with obstructive HCM","volume":"4","author":"Airoldi","year":"2007","journal-title":"Nat. Clin. Pract. Cardiovasc. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1016\/j.jacc.2015.07.069","article-title":"Transaortic chordal cutting: Mitral valve repair for obstructive hypertrophic cardiomyopathy with mild septal hypertrophy","volume":"66","author":"Ferrazzi","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1016\/j.amjcard.2018.06.055","article-title":"Clinical spectrum and management implications of left ventricular outflow obstruction with mild ventricular septal thickness in hypertrophic cardiomyopathy","volume":"122","author":"Rowin","year":"2018","journal-title":"Am. J. Cardiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1093\/ejcts\/ezx398","article-title":"Does septal thickness influence outcome of myectomy for hypertrophic obstructive cardiomyopathy?","volume":"53","author":"Nguyen","year":"2018","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.echo.2017.11.016","article-title":"Intraoperative two- and three-dimensional transesophageal echocardiography in combined myectomy-mitral operations for hypertrophic cardiomyopathy","volume":"31","author":"Nampiaparampil","year":"2018","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1016\/S0002-9149(02)02694-2","article-title":"Impact of intraoperative transesophageal echocardiography in the surgical management of hypertrophic cardiomyopathy","volume":"90","author":"Ommen","year":"2002","journal-title":"Am. J. Cardiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.echo.2019.08.021","article-title":"Intraoperative provocative testing in patients with obstructive hypertrophic cardiomyopathy undergoing septal myectomy","volume":"33","author":"Elsayes","year":"2020","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.athoracsur.2005.01.064","article-title":"Beyond extended myectomy for hypertrophic cardiomyopathy: The resection-plication-release (RPR) repair","volume":"80","author":"Balaram","year":"2005","journal-title":"Ann. Thorac. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.ccl.2018.08.006","article-title":"Surgical myectomy: Subaortic, midventricular, and apical","volume":"37","author":"Nguyen","year":"2019","journal-title":"Rev. Cardiol. Clin."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1016\/j.athoracsur.2020.05.182","article-title":"Transapical septal myectomy for hypertrophic cardiomyopathy with midventricular obstruction","volume":"111","author":"Sun","year":"2021","journal-title":"Ann. Thorac. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1053\/j.semtcvs.2018.02.034","article-title":"Surgical approaches to hypertrophic obstructive cardiomyopathy","volume":"30","author":"Solomon","year":"2018","journal-title":"Semin. Thorac. Cardiovasc. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.jacc.2005.02.090","article-title":"Long-term effects of surgical septal myectomy on survival in patients with obstructive hypertrophic cardiomyopathy","volume":"46","author":"Ommen","year":"2005","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2080","DOI":"10.1093\/eurheartj\/ehs064","article-title":"A contemporary European experience with surgical septal myectomy in hypertrophic cardiomyopathy","volume":"33","author":"Iacovoni","year":"2012","journal-title":"Eur. Heart. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1002\/ejhf.1038","article-title":"Long-term outcomes for different surgical strategies to treat left ventricular outflow tract obstruction in hypertrophic cardiomyopathy","volume":"20","author":"Collis","year":"2018","journal-title":"Eur. J. Heart. Fail."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"353","DOI":"10.21037\/acs.2017.07.07","article-title":"Results of surgical septal myectomy for obstructive hypertrophic cardiomyopathy: The Tufts experience","volume":"6","author":"Rastegar","year":"2017","journal-title":"Ann. Cardiothorac. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.ahj.2019.11.020","article-title":"Comparison of expected and observed outcomes for septal myectomy in hypertrophic obstructive cardiomyopathy","volume":"221","author":"Geske","year":"2020","journal-title":"Am. Heart. J."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1016\/j.jtcvs.2016.12.038","article-title":"Why we need more septal myectomy surgeons: An emerging recognition","volume":"154","author":"Maron","year":"2017","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2076","DOI":"10.1161\/CIRCULATIONAHA.118.035484","article-title":"Case for earlier surgical myectomy in patients with obstructive hypertrophic cardiomyopathy","volume":"138","author":"Maron","year":"2018","journal-title":"Circulation"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.ijcard.2018.09.004","article-title":"Timing of invasive septal reduction therapies and outcome of patients with obstructive hypertrophic cardiomyopathy","volume":"273","author":"Cavigli","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2374","DOI":"10.1161\/CIRCULATIONAHA.111.076257","article-title":"Survival after alcohol septal ablation for obstructive hypertrophic cardiomyopathy","volume":"126","author":"Sorajja","year":"2012","journal-title":"Circulation"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1002\/clc.23113","article-title":"Alcohol septal ablation vs myectomy for symptomatic hypertrophic obstructive cardiomyopathy: Systematic review and meta-analysis","volume":"42","author":"Osman","year":"2019","journal-title":"Clin. Cardiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1136\/heartjnl-2012-303339","article-title":"Alcohol septal ablation in patients with hypertrophic obstructive cardiomyopathy: Low incidence of sudden cardiac death and reduced risk profile","volume":"99","author":"Jensen","year":"2013","journal-title":"Heart"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.jacc.2017.02.080","article-title":"Alcohol septal ablation for obstructive hypertrophic cardiomyopathy: A word of endorsement","volume":"25","author":"Liebregts","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1067\/mje.2000.108250","article-title":"Targeting percutaneous transluminal septal ablation for hyper-trophic obstructive cardiomyopathy by intraprocedural echocardiographic monitoring","volume":"13","author":"Faber","year":"2000","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1007\/s10741-018-9706-z","article-title":"Transcatheter septal ablation in hypertrophic obstructive cardiomyopathy: A technical guide and review of published results","volume":"23","author":"Rigopoulos","year":"2018","journal-title":"Heart Fail. Rev."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2503","DOI":"10.1161\/01.CIR.0000165084.28065.01","article-title":"Early onset and progression of left ventricular re-modeling after alcohol septal ablation in hypertrophic obstructive cardiomyopathy","volume":"111","author":"Beek","year":"2005","journal-title":"Circulation"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1016\/j.amjcard.2005.12.040","article-title":"Time course of pressure gradient response after first alcohol septal ablation for obstructive hypertrophic cardiomyopathy","volume":"97","author":"Yoerger","year":"2006","journal-title":"Am. J. Cardiol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.jacc.2006.08.055","article-title":"Comparison of surgical septal myectomy and alcohol septal ablation with cardiac magnetic re-sonance imaging in patients with hypertrophic obstructive cardiomyopathy","volume":"49","author":"Valeti","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e005735","DOI":"10.1161\/JAHA.117.005735","article-title":"Outcome of alcohol septal ablation in mildly symptomatic patients with hypertrophic obstructive cardiomyopathy: A long-term follow-up study based on the Euro-Alcohol Septal Ablation Registry","volume":"6","author":"Veselka","year":"2017","journal-title":"Am. Heart Assoc."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1016\/j.amjcard.2003.12.065","article-title":"Permanent pacing for complete atrioventricular block after nonsurgical (alcohol) septal reduction in patients with obstructive hypertrophic cardiomyopathy","volume":"93","author":"Reinhard","year":"2004","journal-title":"Am. J. Cardiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.jacc.2017.06.011","article-title":"Alcohol Septal Ablation for Obstructive Hypertrophic Cardiomyopathy A Word of Balance","volume":"70","author":"Sorajja","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1161\/CIRCHEARTFAILURE.109.862359","article-title":"Long-term outcome of alcohol septal ablation in patients with obstructive hypertrophic cardiomyopathy a word of caution","volume":"3","author":"Soliman","year":"2010","journal-title":"Circ. Heart Fail."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2712","DOI":"10.1111\/jce.14679","article-title":"Cardiac implantable electronic device placement following alcohol septal ablation for hypertrophic cardiomyopathy in the United State","volume":"31","author":"Lam","year":"2020","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.jchf.2014.07.008","article-title":"Revisiting arrhythmic risk after alcohol septal ablation is the pendulum finally swinging. Back to Myectomy?","volume":"2","author":"Maron","year":"2014","journal-title":"JACC Heart Fail."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"f198","DOI":"10.1093\/europace\/eux251","article-title":"Validation of the HCM Risk-SCD model in patients with hy-pertrophic cardiomyopathy following alcohol septal ablation","volume":"20","author":"Liebregts","year":"2018","journal-title":"Europace"},{"key":"ref_62","first-page":"793","article-title":"Obstruction after alcohol septal ablation is associated with cardiovascular mortality events","volume":"15","author":"Veselka","year":"2016","journal-title":"Heart"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.jtcvs.2018.08.062","article-title":"Surgical myectomy versus alcohol septal ablation for obstructive hypertrophic cardiomyopathy: A propensity score-matched cohort","volume":"157","author":"Nguyen","year":"2019","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.5114\/aoms.2020.97969","article-title":"Long-term outcome of repeated septal reduction therapy after alcohol septal ablation for hypertrophic obstructive cardiomyopathy: Insight from the Euro-ASA registry","volume":"16","author":"Veselka","year":"2020","journal-title":"Arch. Med. Sci."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1111\/joic.12068","article-title":"Septal perforator anatomy and variability of perfusion bed by myocardial contrast echocardiography: A study of hypertrophic cardiomyopathy patients undergoing alcohol septal ablation","volume":"26","author":"Wallace","year":"2013","journal-title":"J. Interven. Cardiol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/S0025-6196(11)63224-2","article-title":"Anatomy of the first septal perforating artery: A study with implications for ablation therapy for hypertrophic cardiomyopathy","volume":"76","author":"Singh","year":"2001","journal-title":"Mayo Clin. Proc."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/j.cjca.2014.04.008","article-title":"Angiographic and echocardiographic correlates of suitable septal perforators for alcohol septal ablation in hypertrophic obstructive cardiomyopathy","volume":"30","author":"Chan","year":"2014","journal-title":"Can. J. Cardiol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1001\/jamacardio.2016.0252","article-title":"Hospital volume outcomes after septal myectomy and alcohol septal ablation for treatment of obstructive hypertrophic cardiomyopathy US Nationwide Inpatient Database, 2003\u20132011","volume":"1","author":"Kim","year":"2016","journal-title":"JAMA Cardiol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.cjca.2017.10.020","article-title":"Effect of institutional experience on outcomes of alcohol septal ablation for hypertrophic obstructive cardiomyopathy","volume":"34","author":"Veselka","year":"2018","journal-title":"Can. J. Cardiol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1002\/ccd.24643","article-title":"Alcohol septal ablation for obstructive hypertrophic cardiomyopathy: Outcomes in young, middle-aged, and elderly patients","volume":"82","author":"Leonardi","year":"2013","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1253\/circj.70.880","article-title":"Age-related hemodynamic and morphologic differences in patients undergoing alcohol septal ablation for hypertrophic obstructive cardiomyopathy","volume":"70","author":"Veselka","year":"2006","journal-title":"Circ. J."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1093\/eurheartj\/ehz110","article-title":"Short- and long-term outcomes of alcohol septal ablation for hypertrophic obstructive cardiomyopathy in patients with mild left ventricular hypertrophy: A propensity score matching analysis","volume":"40","author":"Veselka","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1136\/heartjnl-2019-315422","article-title":"Alcohol septal ablation in patients with severe septal hypertrophy","volume":"106","author":"Veselka","year":"2020","journal-title":"Heart"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/10\/2166\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:02:49Z","timestamp":1760162569000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/10\/2166"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,17]]},"references-count":73,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["jcm10102166"],"URL":"https:\/\/doi.org\/10.3390\/jcm10102166","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,17]]}}}