Rescue alcohol septal ablation in sepsis with multiorgan failure

Barwad, Parag W. ; Ramakrishnan, S. ; Seth, Sandeep ; Bhargava, Balram (2012) Rescue alcohol septal ablation in sepsis with multiorgan failure Indian Heart Journal, 64 (6). pp. 588-590. ISSN 0019-4832

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Official URL: https://www.sciencedirect.com/science/article/pii/...

Related URL: http://dx.doi.org/10.1016/j.ihj.2012.09.004

Abstract

A 55 year old male patient with a diagnosis of hypertrophic cardiomyopathy was admitted with features of sepsis related to cholangitis. Initial management with intravenous (i.v.) fluids and antibiotics did not cause any change in his general condition mandating an emergency endoscopic retrograde cholangio-pancreatography (ERCP). After successful retrieval of CBD stone on ERCP, patient had massive upper gastrointestinal bleed leading to hypotension and shock. Addition of inotropes had led to further deterioration in his clinical status with a mean arterial BP falling to 44 mm of Hg. His echocardiography showed a resting left ventricular outflow tract (LVOT) gradient of 90 mm of Hg and thus was taken up for emergency alcohol septal ablation (ASA). Immediately after ASA, patient had significant decrease in LVOT obstruction and rise of systemic arterial pressures. After 10 days of antibiotic therapy patient was discharged with a residual LVOT obstruction of 28 mm of Hg.

Item Type:Article
Source:Copyright of this article belongs to Cardiological Society of India.
Keywords:Hypertrophic Cardiomyopathy – HCM; Alcohol Septal Ablation – ASA; Left Ventricular Outflow Tract – LVOT; Sepsis; Multiorgan Dysfunction
ID Code:114496
Deposited On:30 May 2018 11:21
Last Modified:30 May 2018 11:21

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