Morphology of necrosis and repair after transcoronary ethanol ablation of septal hypertrophy.

The transcoronary ethanol ablation of septum hypertrophy (TASH) results in a necrosis of the myocardium. In contrast to the ischemically induced necrosis, there is not any phagocytosis caused by leukocytes and macrophages, nor does transformation into granulation tissue occur. Even six months after the application of ethanol, the myofibrils can be identified as "ghost cells" surrounded by a web of collagen fibers. This special forming of a scar, unknown to this day, is documented by 13 patients who died between 25 minutes and two years after ethanol-induced ablation of the hypertrophic septum in hypertrophic obstructive cardiomyopathiy (HOCM).