Alcohol septal ablation with septal myocardial isolation using the double-balloon method for refractory hypertrophic obstructive cardiomyopathy

An 86-year-old woman had been referred to our institution for alcohol septal ablation (ASA) because of drug-refractory hypertrophic obstructive cardiomyopathy. The resting pressure gradient of the left ventricular outflow tract was 135 mmHg on echocardiography. After an over-the-wire balloon (Apex OTW®; 1.5/8 mm; Boston Scientific) was inflated in the first septal branch, a selective septal angiography revealed a small …