Alcohol septal ablation in a patient with Fabry disease and multilevel left ventricular obstruction. A case report
https://doi.org/10.15829/1560-4071-2025-6295
EDN: GXOQST
Abstract
Introduction. Fabry disease (FD) can mimic hypertrophic cardiomyopathy and be accompanied by left ventricular outflow tract obstruction or midventricular obstruction. In the case of intraventricular obstruction and refractory heart failure, septal reduction may be considered.
Brief description. We present a case of alcohol septal ablation (ASA) in a female patient with genetically confirmed FD and symptomatic multilevel intraventricular obstruction. She underwent transcatheter ASA with subsequent elimination of midventricular obstruction and left ventricular outflow tract obstruction. The hemodynamic effect was maintained during the next 3-month follow-up.
Discussion. Our case shows the fact that ASA can be effective and safe in eliminating obstruction in patients with FD, provided that intracardiac hemodynamics are further monitored.
About the Authors
M. G. Kashtanov
Tyumen Cardiology Research Center, Tomsk National Research Medical Center; Ural Federal University
Russian Federation
Competing Interests:
Russian Federation
Tyumen, Yekaterinburg
Competing Interests:
none
A. A. Vedernikov
Tyumen Region Regional Clinical Hospital № 1
Russian Federation
Competing Interests:
Russian Federation
Tyumen
Competing Interests:
none
E. M. Mezhonov
Tyumen Region Regional Clinical Hospital № 1; Tyumen State Medical University
Russian Federation
Competing Interests:
Russian Federation
Tyumen
Competing Interests:
none
E. S. Raspopova
Tyumen Region Regional Clinical Hospital № 1
Russian Federation
Competing Interests:
Russian Federation
Tyumen
Competing Interests:
none
O. M. Reitblat
Tyumen Region Regional Clinical Hospital № 1
Russian Federation
Competing Interests:
Russian Federation
Tyumen
Competing Interests:
none
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Supplementary files
- Fabry disease (FD) cardiomyopathy may mimic
hypertrophic cardiomyopathy and be associated with outflow tract obstruction and even midventricular obstruction. - Worldwide experience with septal reduction in patients with FD is limited to case reports and small case series.
- To our knowledge, we present the first case of alcohol septal ablation in a patient with FD and multilevel obstruction.
- Safety and efficacy of alcohol septal ablation in a patient with FD are demonstrated.
- Accumulating experience with similar procedures will contribute to the accumulation of knowledge regarding their effects on clinical and multimodality imaging parameters, and possibly improve outcomes in this population.
Review
For citations:
Kashtanov M.G., Vedernikov A.A., Mezhonov E.M., Raspopova E.S., Reitblat O.M. Alcohol septal ablation in a patient with Fabry disease and multilevel left ventricular obstruction. A case report. Russian Journal of Cardiology. 2025;30(10S):6295. (In Russ.) https://doi.org/10.15829/1560-4071-2025-6295. EDN: GXOQST
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