OPTEM-oHCM: OPtimal Targeted Polymer-based EMbolization for Obstructive Hypertrophic CardioMyopathy.

BACKGROUND

Obstructive hypertrophic cardiomyopathy often requires septal reduction in symptomatic patients, but standard alcohol septal ablation may be limited in some cases.

CASE SUMMARY: A 72-year-old woman presented with dyspnea and syncope. Investigations revealed dynamic left ventricular outflow tract gradient up to 167 mm Hg. Targeted embolization using ethylene-vinyl alcohol copolymer on septal and circumflex branches achieved complete gradient resolution.

DISCUSSION: This case demonstrates polymer-based embolization as a feasible alternative for complex cases, offering precise targeting beyond traditional septal branches, aligned with current guidelines for nonsurgical candidates.

TAKE-HOME MESSAGES: Polymer embolization provides effective left ventricular outflow tract relief in obstructive hypertrophic cardiomyopathy with atypical supply. Functional balloon testing optimizes outcomes in high-risk patients.