Heart failure & cardiomyopathies
Septal scoring along the midline endocardium (SESAME) technique: septal scoring along the midline endocardium
Authors' conclusion
Our study corroborates the feasibility and efficacy of SESAME for prohibitive surgical risk patients needing septal reduction therapy prior to TMVR or for treatment of oHCM or a subaortic membrane.
Study context
- Population
- Patients who underwent the SESAME procedure at the University of Washington from January 2022 to September 2024consecutive patients who underwent SESAME
- Participants
- 54 patients
- Exposure
- pre-TMVR vs obstructive hypertrophic cardiomyopathy (oHCM) vs subaortic membrane
- pre-TMVRn = 47
- oHCMn = 6
- Subaortic membranen = 1
- Outcome
- Technical success
Main finding
As reported in the abstract
Technical success
100%
Observational data: associations, not effects.
Further findings
Neo-LVOT and skirt neo-LVOT areas gained (pre-TMVR)
mm²
- Median neo-LVOT area gained
- 146 (Q1: 76.5, Q3: 286.3)
- Median skirt neo-LVOT area gained
- 54 (Q1: 32.8, Q3: 100.2)
Invasive LVOT gradients (oHCM) · immediately
mmHg
- Resting LVOT gradient, before
- 59 (Q1: 32, Q3: 99)
- Resting LVOT gradient, after
- 10 (Q1: 5, Q3: 19)
- Provocable LVOT gradient, before
- 121 (Q1: 53, Q3: 205)
- Provocable LVOT gradient, after
- 34 (Q1: 16, Q3: 56)
Median echo gradients (oHCM) · 30 days
mmHg
- Baseline
- 62 (Q1: 53, Q3: 64)
- 30 days
- 6 (Q1: 6, Q3: 8)
Safety
Procedural complications (pre-TMVR population)
- Procedural deaths from free-wall rupture early in the experience
- 2
- Restrictive ventricular septal defects that did not require intervention
- 3
Pacemaker requirement
- Required a pacemaker
- Three patients (5.5%)
Procedural complications after the first 10 cases in 2022
- Significantly decreased
- P < 0.01
Original publication
SESAME technique: septal scoring along the midline endocardium. EuroIntervention. Published 18 August 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →