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alcohol septal ablation
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.
== History ==
Alcohol septal ablation was first performed in Britain at the Royal Brompton Hospital by Ulrich Sigwart in 1994.〔Sigwart U.; ''Non-surgical myocardial reduction for hypertrophic obstructive cardiomyopathy''; Lancet. 1995 Jul 22;346(8969):211-4; PMID 7616800〕 Since that time, it has quickly gained favor among physicians and patients alike due to its minimally-invasive nature, avoiding general anesthesia, lengthy recuperation and other complications associated with open heart surgery (septal myectomy).
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