Time-dependent response of both ventricles after septal ablation: Implications for biventricular support after left ventricular assist device placement

A, Postprocedural angiogram showing acute closure of the main septal perforating artery, which is circled in preprocedural angiogram (B). Sham (C, D) and ablation (E, F) postmortem hearts after differential staining with 1% triphenyltetrazolium solution and methylene blue dye at 4 weeks. Extensive fibrosis (white) is seen on the left (E) and right (F) septal surfaces after ablation compared with corresponding undamaged, triphenyltetrazolium-stained red areas (C, D) after a sham procedure.

Effect of ethanol ablation (filled squares) on LV peak systolic pressure, RV peak systolic pressure, RV end-diastolic pressure, CVP, and pulmonary wedge pressure compared with sham (open squares) at baseline, 15 minutes after ethanol ablation, and 4 weeks (mean ± standard deviation [SD]; *P < .001). LV, Left ventricular; RV, right ventricular; ESP, end-systolic pressure; PWP, pulmonary wedge pressure; PSP, peak systolic pressure; EDP, end-diastolic pressure; CVP, central venous pressure.

Comparison of LV and RV parameters in response to ethanol ablation. (A) EF, (B) PRSW, (C) end-systolic elastance, and (D) Tau (mean ± SD; *P < .001). LV, Left ventricular; RV, right ventricular; BL, baseline.

Effect of ethanol ablation (filled squares) on LV end-diastolic and systolic volumes, RV end-diastolic and systolic volumes, and biventricular (summed LV and RV) end-diastolic and systolic volumes compared with sham (open squares) at baseline, 15 minutes after ethanol ablation, and 4 weeks (mean ± SD; *P < .001). There is divergence between RV and LV volumes acutely after ablation, compared with sham response. In contrast, biventricular volumes remain stable. Acute changes in volume seen in ablation animals return to sham levels after 4 weeks (mean ± SD; *P < .001). BiV, Biventricular; RV, right ventricular; LV, left ventricular; ESV, end-systolic volume; EDV, end-diastolic volume.