ECHOCARDIOGRAPHY SHOW THICK SEPTAL BRANCHES BEEFORE THE PROCEDURE (LFET) "BLACK HOLES" AS A RESULT OF ABLATION INDICATED IN THE POSTOPERATIVE ECHOCARDIOGRAPHY (RIGHT)

Zhejiang's first Liwen procedure (percutaneous intramyocardial septal radiofrequency ablation) is performed by SAHZU's Prof. WANG Jian'an and his team on July 1. After the procedure, patients' blood pressure dropped to the normal range and symptoms were greatly released. SAHZU becomes one of the few medical centers in China that can perform this novel heart procedure.

Hypertrophic obstructive cardiomyopathy (HOCM) is an inherited heart condition in which the patient’s heart muscle is abnormally and asymmetrically thick. It is the leading cause of sudden cardiac death after exercise of teenagers. HOCM could have variable clinical manifestations. Some people with HOCM may have no significant problems, while for others, sudden cardiac death might be their initial onset. The most common sign and symptom of the disease is shortness of breath and/or fatigue, especially with physical exertion. Chest pain, arrhythmias or fainting are also widely observed. 

Treatment approaches to HOCM are mainly medication therapy, alcohol septal ablation, and surgical procedures. However, not all patients are physically strong enough to undergo surgeries or alcohol septal ablation. And, there are currently no disease-specific medications for hypertrophic cardiomyopathy. 

GASIFICATION DURING ABLATION

Liwen procedure, however, is a safe, effective, and micro-invasive treatment approach for HOCM that is invented and developed in China. During the procedure, the cardiologist inserts a radiofrequency needle percutaneously, through patient's fifth intercostal space, into his ventricular apex under ultrasound guidance. Once reaching the obstructive spot along the intraventricular septum, the cardiologist would ablate the myocardium as well as the anterior and posterior septum including the coronary artery branches that feed blood to the thick heart muscle.

Much less invasive than open heart surgery, the Liwen procedure can be performed regardless of the configuration of septal branches. Moreover, the needle is inserted between the left and right bundle branches, thus there is lower risk of bundle branch block. 

Want to know more about the procedure? Please click the link to see a video demo.