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Alcohol septal ablation was first performed in 1994 by Ulrich Sigwart at the Royal Brompton Hospital in the United Kingdom. [2] Since that time, it has gained favor among physicians and patients due to its minimally invasive nature, thereby avoiding general anesthesia, lengthy inpatient recuperation and other complications associated with open-heart surgery (e.g. septal myectomy).
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.
In a select population with symptoms secondary to a high outflow tract gradient, alcohol septal ablation can reduce the symptoms of HCM. In addition, older individuals and those with other medical problems, for whom surgical myectomy would pose increased procedural risk, would likely benefit from the less-invasive septal ablation procedure. [15 ...
These are specially equipped operating rooms that usually contain an X-ray machine capable of acquiring live X-ray video images (a fluoroscope), equipment to record electrical signals from the heart, a stimulator to electrically excite the heart and control the heart rate, and ablation equipment to destroy abnormal tissue. [3]
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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 ]
The Cox maze procedure, also known as maze procedure, is a type of heart surgery for atrial fibrillation. "Maze" refers to the series of incisions arranged in a maze-like pattern in the atria.
For patients with the most common type of mitral valve disease, termed "degenerative" or "myxomatous" mitral valve disease, repair rates are very high and long term durability is excellent. [4] There has been great debate about timing of surgery in patients with asymptomatic mitral valve regurgitation.