Editorial
Five years of percutaneous transluminal septal myocardial ablation
| The first 150 words of the full text of this article appear below. |
In June
1994, Ulrich Sigwart injected a small quantity of absolute alcohol into
the first septal artery of a 67 year old woman with hypertrophic
obstructive cardiomyopathy.1 The objective of this
somewhat alarming manoeuvre was to produce an area of localised
myocardial infarction in the left ventricular outflow tract
in effect
producing a chemical myotomy-myectomy, without recourse to open heart
surgery. Five years on, the technique has been applied by a number of
groups in a few hundred patients worldwide.
The birth of the Sigwart procedure (percutaneous transluminal septal
myocardial ablation, transcoronary ablation of septal hypertrophy,
non-surgical septal reduction) was not greeted with unanimous approval
from the community of physicians treating patients with this
troublesome condition. A number of eminent commentators have referred
to the procedure's "profoundly aggressive" nature and its
associated "unacceptably high mortality and
morbidity".2 Clearly such comments were made at a very
early point in the technique's development; it
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This article has been cited by other articles:
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Chang, S. M., Nagueh, S. F., Spencer, W. H. III, Lakkis, N. M.
(2003). Complete heart block: determinants and clinical impact in patients with hypertrophic obstructive cardiomyopathy undergoing nonsurgical septal reduction therapy. J Am Coll Cardiol
42: 296-300
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