Cardiomyopathy surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Lina Ya'qoub, MD; Edzel Lorraine Co, DMD, MD[2]

## Overview[edit | edit source]

There are several types of surgery used to treat cardiomyopathy. They include septal ablation, septal myectomy, surgically implanted devices to improve the function of the heart, and heart transplant.

## Surgery[edit | edit source]

### Septal Ablation[edit | edit source]

Doctors may use a nonsurgical procedure called alcohol septal ablation to treat cardiomyopathy. For this procedure, the doctor injects ethanol (a type of alcohol) through a tube into the small artery that supplies blood to the thickened area of heart muscle. The alcohol kills cells, and the thickened tissue shrinks to a more normal size.[1]

This procedure allows blood to flow freely through the ventricle, which improves symptoms.

### Septal Myectomy[edit | edit source]

Septal myectomy is open-heart surgery. It's used for patients who have obstructive hypertrophic cardiomyopathy and severe symptoms. This surgery generally is used for younger patients and for people whose medicines aren't working well. During the surgery, the surgeon removes part of the thickened septum that's bulging into the left ventricle. This improves blood flow through the heart and out to the body. The removed tissue doesn't grow back. The surgeon also can repair or replace the mitral valve at the same time (if needed). Septal myectomy often is successful and allows the patients to return to a normal life with no symptoms.[1]

### Surgically Implanted Devices[edit | edit source]

There are several types of devices that can be implanted in the heart to help it work better. One example is a pacemaker. This is a small device that's placed under the skin of the chest or abdomen to help control arrhythmias. The device uses electrical pulses to prompt the heart to beat at a normal rate. Sometimes doctors choose to use a cardiac resynchronization therapy (CRT) device. A CRT device coordinates contractions between the heart's left and right ventricles.

A left ventricular assist device (LVAD) helps the heart pump blood to the body. An LVAD can be used as a long-term therapy or as a short-term treatment for people who are waiting for a heart transplant.

An implantable cardioverter defibrillator (ICD) helps control life-threatening arrhythmias that may lead to SCA. This small device is implanted in the chest or abdomen and connected to the heart with wires.

If an ICD senses a dangerous change in heart rhythm, it will send an electric shock to the heart to restore a normal heartbeat.

### Heart Transplant[edit | edit source]

Heart transplant has been increasingly used as a last resort for patients with end-stage cardiomyopathy. For this surgery, a surgeon replaces a person's diseased heart with a healthy heart from a deceased donor. A heart transplant is a last resort treatment for people who have end-stage heart failure. "End-stage" means the condition has become so severe that all treatments, other than heart transplant, have failed

## References[edit | edit source]

1. ↑ 1.0 1.1 Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL (October 2013). "2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J. Am. Coll. Cardiol. 62 (16): e147–239. doi:10.1016/j.jacc.2013.05.019. PMID 23747642.

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