Alcohol septal ablation for left ventricular outflow tract obstruction in cardiac amyloidosis: New indication for an established therapy

Case Reports

. 2022 Sep 24.

doi: 10.1002/ccd.30411.

Online ahead of print.


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Case Reports

Lauren E Fanta et al.

Catheter Cardiovasc Interv.



Cardiac amyloidosis can occasionally demonstrate an atypical pattern of infiltration, causing asymmetric septal thickening and a left ventricular outflow tract (LVOT) gradient with systolic anterior motion (SAM) of the mitral valve resembling obstructive hypertrophic cardiomyopathy. We present a case of a 70-year-old man with cardiac light-chain amyloidosis and LVOT obstruction successfully treated with alcohol septal ablation (ASA). Following the procedure, he reported significant improvement in his heart failure symptoms as well as improvement in LVOT gradient and SAM of the mitral valve. This case demonstrates that ASA is a technically feasible and effective procedure for relieving LVOT obstruction in cardiac amyloidosis and can be considered as a treatment option in patients whose symptoms are refractory to medical therapy.


alcohol septal ablation; cardiac amyloidosis.



    1. Falk RH, Alexander KM, Liao R, Dorbala S. AL (light-chain) cardiac amyloidosis: A review of diagnosis and therapy. J Am Coll Cardiol. 2016;68(12):1323-1341.

    1. Sattar Y, Ruiz Maya T, Zafrullah F, Patel NB, Latchana S. Diagnosis and management of a cardiac amyloidosis case mimicking hypertrophic cardiomyopathy. Cureus. 2018;10(12):e3749.

    1. Dinwoodey DL, Skinner M, Maron MS, Davidoff R, Ruberg FL. Light-chain amyloidosis with echocardiographic features of hypertrophic cardiomyopathy. Am J Cardiol. 2008;101(5):674-676.

    1. Murphy RT, Ratliff NB, Lever HM, Kapadia SR. Use of percutaneous transluminal septal myocardial ablation for relief of outflow tract obstruction in cardiac amyloidosis: a novel therapeutic target. Catheter Cardiovasc Interv. 2006;68(4):637-641.

    1. Ommen SR, Mital S, Burke MA, et al. 2020 AHA/ACC guideline for the diagnosis and treatment of patients with hypertrophic cardiomyopathy: executive summary: A report of the American College of Cardiology/American heart association joint committee on clinical practice guidelines. J Am Coll Cardiol. 2020;76(25):3022-3055.

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