Abstract 16161: Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy: Good for Any Age?
Introduction: Alcohol septal ablation (ASA) is an accepted non-surgical therapy for septal reduction in patients with medically refractory Hypertrophic Obstructive Cardiomyopathy (HOCM). We sought to determine the relative efficacy of ASA across ages.
Methods: We divided 405 consecutive patients treated with ASA at our institution into age groups of those <45 years old (n=115), 45 to 64 years old (n=166), and those 65 and older (n=124). Major procedural complications included permanent pacing, remote alcohol related infarction, coronary artery dissection, bleeding, peripheral vascular events, sustained arrhythmias, right ventricular perforation and procedure related death. Outcomes were New York Heart Association (NYHA) heart failure class and echocardiographic gradients at 3 and 12 months as well as 12 month post-procedure mortality.
Results: Compared with the patients 65 compared with those 45-64 years old (22.5% vs 9.6%, p=0.004; Figure 1B). All groups had a significant reduction in gradients from baseline (Figure 1C). At 3 months, the average NYHA score was lower in the middle age group compared with those <45 (1.38 vs 1.61, p=0.01), however by 12 months there was no difference between groups. The post-procedure one-year mortality rate was not statistically different between groups (Figure 1D).
Conclusions: Despite a patient population with more comorbidities at baseline and a higher rate of procedural complications, older patients showed a sustained improvement in symptoms and gradients similar to their younger counterparts.
- © 2011 by American Heart Association, Inc.