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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.
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.
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CABG is also indicated when there are mechanical complications of an infarction (ventricular septal defect, papillary muscle rupture or myocardial rupture). [8] There are no absolute contraindications of CABG, but severe disease of other organs such as the liver or brain, limited life expectancy, and patient fragility are considered.
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.
Off-pump coronary artery bypass (OPCAB), or beating-heart surgery, is a form of coronary artery bypass graft (CABG) surgery performed without cardiopulmonary bypass (heart-lung machine) as a treatment for coronary heart disease.
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.
Srihari S. Naidu is an American physician and Professor of Medicine at New York Medical College who is known for his work on hypertrophic cardiomyopathy including the procedure known as alcohol septal ablation, and for helping to construct the universal diagnostic criteria for cardiogenic shock.