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Fig. 25. Septal ablation: intraprocedural echocardiography. Images from the same patient in Fig. 23 are obtained pre- and postseptal ablation. At baseline (A) in the cardiac catheterization suite, resting gradient was 50 mm (B) increasing to 100 mmHg with Valsalva (C). Cannulation of the septal artery supplying the offending septal region followed by slow infusion of dehydrated alcohol to ablate the same. Echocardiographic staining of the injected septal region is evident (D). Immediately postprocedure, the resting gradient fell remarkably at baseline (E) and during Valsalva (E). Repeat echocardiography done 2 wk later showed continued echocardiographic and clinical improvement.

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