open access

Vol 15, No 1 (2008)
Case Reports
Published online: 2007-12-17
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Hypertrophic obstructive cardiomyopathy in liver transplant patients

Fadi G. Hage, Paco E. Bravo, Gilbert J. Zoghbi, John S. Bynon, Raed A. Aqel
Cardiol J 2008;15(1):74-79.

open access

Vol 15, No 1 (2008)
Case Reports
Published online: 2007-12-17

Abstract

The optimal treatment strategy for patients with symptomatic hypertrophic obstructive cardiomyopathy (HOCM) and end-stage liver disease (ESLD) is not well defined. Although medical management is the accepted first line treatment, patients who are unresponsive to medication require further interventions. Since ESLD patients have a high operative risk for surgical myomectomy, alcohol septal ablation (ASA) emerges as a good alternative in these cases. The timing of ASA in relation to liver transplantation is still unclear. We report here on the first case of an orthotopic liver transplant-recipient undergoing ASA and the second of a cirrhotic patient requiring ASA as a bridge to liver transplantation. Both patients had a good clinical outcome and we argue that ASA in HOCM patients should be driven by symptom onset, and that in the asymptomatic patient it can be safely deferred until after liver transplantation. (Cardiol J 2008; 15: 74-79)

Abstract

The optimal treatment strategy for patients with symptomatic hypertrophic obstructive cardiomyopathy (HOCM) and end-stage liver disease (ESLD) is not well defined. Although medical management is the accepted first line treatment, patients who are unresponsive to medication require further interventions. Since ESLD patients have a high operative risk for surgical myomectomy, alcohol septal ablation (ASA) emerges as a good alternative in these cases. The timing of ASA in relation to liver transplantation is still unclear. We report here on the first case of an orthotopic liver transplant-recipient undergoing ASA and the second of a cirrhotic patient requiring ASA as a bridge to liver transplantation. Both patients had a good clinical outcome and we argue that ASA in HOCM patients should be driven by symptom onset, and that in the asymptomatic patient it can be safely deferred until after liver transplantation. (Cardiol J 2008; 15: 74-79)
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Keywords

cardiomyopathy; liver transplantation; liver failure; alcohol; hypertrophy; ablation

About this article
Title

Hypertrophic obstructive cardiomyopathy in liver transplant patients

Journal

Cardiology Journal

Issue

Vol 15, No 1 (2008)

Pages

74-79

Published online

2007-12-17

Bibliographic record

Cardiol J 2008;15(1):74-79.

Keywords

cardiomyopathy
liver transplantation
liver failure
alcohol
hypertrophy
ablation

Authors

Fadi G. Hage
Paco E. Bravo
Gilbert J. Zoghbi
John S. Bynon
Raed A. Aqel

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