Alcohol septal ablation in hypertrophic cardiomyopathy. 3D contrast echocardiography allows localization and quantification of the extension of intraprocedural vascular recruitment.

A 68 year-old female with hypertrophic obstructive cardiomyopathy (HOCM) was referred for alcohol septal ablation (ASA) due to a sustained New York Heart Association (NYHA) functional class III despite optimal medical treatment. Two-dimensional transthoracic echocardiography (2D TTE) confirmed the diagnosis (Panel A), showing a left ventricular outflow tract (LVOT) gradient of 100 mm Hg (Fig. 1).