Hypertrophic Obstructive Cardiomyopathy (HOCM) is a rare disorder characterised by the Thickening of Heart Muscles (Septum Hypertrophy). Usually an asymmetric thickening of the interventricular septum. HOCM is a clearly recognisable genetic disease with an Autosomal Dominant (AD) pattern of inheritance. It is a debilitating condition, which interferes with the patients’ day-to-day activities, eventually leading to premature death.

 

Thus far there has been no definitive treatment for this condition. Alcohol septal ablation has the potential to deliver lasting results with a long-term decrease in symptoms and mortality in patients with HOCM. Infarction of the basal septum with 100% alcohol by a percutaneous procedure called alcohol septal ablation (ASA) relieves the obstruction of the ventricle and improves the symptoms.

 

This 36year old father of one (Attached Patient in the Visuals) with Chest Pain (Angina) and shortness of breath which was limiting and affecting his day-to-day activities was diagnosed with Hypertrophic Obstructive Cardiomyopathy (HOCM).

 

We proceeded with alcohol septal ablation on our patient and ablated the proximal branch of the first septal branch to infarct the basal septum to relieve the obstruction. The procedure ended up a remarkable success, with on-table reduction of pressure gradient of outflow by 50mmHg at the expense of transient complete heart block and post-procedure echocardiography also continued the drop in the outflow pressure gradient by 50mmHg.

 

This treatment will now be performed on a regular basis at the Institute of Cardiology at Colombo National Hospital for the benefit of the 100’s of patients who have been diagnosed with this potentially fatal condition.