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Alcohol septal ablation (ASA) is a minimally invasive heart procedure to treat hypertrophic cardiomyopathy (HCM). [1]It is a percutaneous, minimally invasive procedure performed by an interventional cardiologist to relieve symptoms and improve functional status in eligible patients with severely symptomatic HCM who meet strict clinical, anatomic and physiologic selection criteria.
Septal myectomy is associated with a low perioperative mortality and a high late survival rate. A study at the Mayo Clinic found surgical myectomy performed to relieve outflow obstruction and severe symptoms in HCM was associated with long-term survival equivalent to that of the general population, and superior to obstructive HCM without operation.
When performed properly, an alcohol septal ablation induces a controlled heart attack, in which the portion of the interventricular septum that involves the left ventricular outflow tract is infarcted and will contract into a scar. There is debate over which people are best served by surgical myectomy, alcohol septal ablation, or medical therapy.
Totally endoscopic coronary artery bypass surgery (TECAB) is an entirely endoscopic robotic surgery used to treat coronary heart disease, developed in the late 1990s.It is an advanced form of minimally invasive direct coronary artery bypass surgery, which allows bypass surgery to be conducted off-pump without opening the ribcage.
Minimally invasive direct coronary artery bypass (MIDCAB) is a surgical treatment for coronary heart disease that is a less invasive method of coronary artery bypass surgery (CABG). [1]
According to a study by Eagle et al., patients 50–59 years old have an operative mortality rate of 1.8%, while patients older than 80 have a rate of 8.3%. [33] Other factors that increase mortality are being female, re-operation, dysfunction of the left ventricle, and left main disease . [ 33 ]
Procedures on the mitral valve usually require a median sternotomy, but advances in non-invasive methods (such as keyhole surgery) allow surgery without a sternotomy (and resulting pain and scar). Minimally invasive mitral valve surgery is much more technically demanding and may involve higher risk.
Cardiac surgery through sternotomy is safe and efficient, and is considered to be the gold standard for surgical treatment of all congenital and acquired heart diseases resulting in low failure rates and excellent proven long-term outcomes. [7] Cardiac surgery via median sternotomy is performed in over 1 million patients per year worldwide. [8]