Alcohol septal ablation (ASA, TASH, Sigwart procedure) is a percutaneous, minimally-invasive treatment performed by an interventional cardiologist to relieve symptoms and improve functional status in severely symptomatic patients with hypertrophic cardiomyopathy (HCM) who meet strict clinical, anatomic and physiologic selection criteria. In carefully selected patients, when performed by an experienced interventional cardiologist, the procedure is successful in relieving symptoms in over 90% of patients.
Hypertrophic cardiomyopathy is a condition of the heart muscle which grows abnormally thick, in the absence of a physiologic cause such as hypertension (high blood pressure) or aortic valve disease. In a large subset of patients with hypertrophic obstructive cardiomyopathy, thickening of the heart muscle in a particular part of the interventricular septum causes obstruction to blood being ejected from the left ventricle.
Alcohol septal ablation is a technique designed to reduce the obstruction to blood being ejected from the heart; the technique creates a small controlled heart attack, killing the area of heart muscle responsible for the obstruction, and eventually causing it to become less thick.
... Alcohol septal ablation, introduced by Ulrich Sigwart in 1994, is a percutaneous technique that involves injection of alcohol into one or more septal branches of the left anterior descending artery ... This is a technique with results similar to the surgical septal myectomy procedure but is less invasive, since it does not involve general anaesthesia and ... secondary to a high outflow tract gradient, alcohol septal ablation can reduce the symptoms of HCM ...
... Despite initial concerns regarding long-term arrhythmic potential of alcohol septal ablation, no increased risk has been noted to date ... It is important to note that patients who fail to respond to alcohol septal ablation may still be candidates for surgical myectomy ... who fail surgical myectomy may still respond to alcohol septal ablation ...
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“Men can intoxicate themselves with ideas as effectually as with alcohol or with bang and produce, be dint of serious thinking, mental conditions hardly distinguishable from monomania.”
—Thomas Henry Huxley (182595)