ABSTRACT
Hypertrophic obstructive cardiomyopathy (HOCM) is an important, progressive, lethal type of hypertrophic cardiomyopathy (HCM), which can be effectively palliated both by surgical- and catheter-based techniques: by surgical septal myomectomy (SSM) or by alcohol septal ablation (ASA). This chapter aims primarily at summarising basic technical notions in the application of ASA. Awareness of the importance, mechanisms and lethality of HOCM has become well-established during the last 40 years. HOCM is a term used to indicate a type of HCM featuring sub-aortic obstructive outflow tract, that is the culprit of a rapid progression of this congenital condition. Systolic peak gradient is considered the simplest marker of severity in a given case of HOCM. This index may excessively simplify the complexity of sub-aortic stenosis (SAS) and its prognosis. Preoperative evaluation of a candidate for ASA should be considered one of the most critical aspects of the procedure.
