Alcohol septal ablation in the management of hypertrophic obstructive cardiomyopathy (HOCM)
Hypertrophic cardiomyopathy (HCM) is the most common monogenic heart disease and often associated with symptoms that impair functional status and quality of life. Alcohol septal ablation is a proven interventional treatment for patients with symptomatic, obstructive HCM, with success rates surpassing 95% and procedural mortality less than 1% at experienced centers. This chapter will discuss the clinical presentation of HCM, available diagnostic modalities, and the cardiovascular imaging features that guide candidacy for septal reduction therapies such as alcohol septal ablation or surgical myectomy. Beginning with a case presentation, the authors aim to highlight the imaging considerations involved in the Heart Team's approach to the patient with HCM and severe left ventricular outflow tract obstruction and selection for septal reduction therapy with a focus on procedural guidance for alcohol septal ablation.
