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Alcohol Septal Ablations

Alcohol septal ablation is a non-surgical procedure that is used to treat hypertrophic cardiomyopathy. This is an inherited disease in which your heart muscle becomes abnormally thick.

This thickening may partially block the blood flow from your heart and out to your body. This places extra pressure on your heart. It also contributes to many symptoms of the disease. These may include fatigue and shortness of breath.

Alcohol septal ablation requires a thin, flexible tube called a catheter. It has a balloon at the tip. Your doctor threads the tube through a blood vessel in your groin all the way to the artery that carries blood to your septum.

Your doctor then injects alcohol, through the tube, into the area where the heart is too thick. The alcohol causes some of your heart muscle cells to shrink and die. The remaining scar tissue is thinner than the heart muscle. This "thinning" of the heart muscle improves blood flow.

Why choose Presbyterian for your alcohol septal ablations?

Presbyterian’s Pediatric and Congenital Cardiology team has many different options to help you manage your or your child’s heart condition. The team performs various diagnostic tests and procedures to help form an accurate diagnosis and create individualized treatment plans. Depending on the type of heart condition your child has and its underlying cause, the team can recommend a wide variety of treatment options. Our pediatric cardiologists, pediatric interventional cardiologists, and pediatric cardiovascular surgeons work closely together for cardiac repair or surgery cases is the best treatment option.

Who is eligible for alcohol septal ablations?

For many people with hypertrophic cardiomyopathy, medicines are enough to treat the condition. However, some people don't respond well to the medications and may benefit from alcohol septal ablation.

Septal myectomy is another option for many people considering alcohol septal ablation. Both procedures decrease the thickness of the septum.In septal myectomy, a surgeon removes muscle from the thickened septum. Because septal myectomy is open-heart surgery, it takes longer to recover. However, alcohol septal ablation may bring other problems, such as the need for a pacemaker.

Your doctor can help you decide about each technique's risks and benefits and what will work best for you. Alcohol septal ablation is usually better for older people and in those whose thickening is less severe.

If you have other heart abnormalities that require repair, you may need a septal myectomy instead.

What condition is treated with alcohol septal ablations?

Alcohol septal ablations are used to treat hypertrophic cardiomyopathy, a thickening of the heart muscle.

How do I prepare for alcohol septal ablations?

Make sure your healthcare provider knows all the medicines you take. You may need to stop taking certain medicines before the procedure, such as beta-blockers. Do not drink or eat anything after midnight the day before your procedure.

You may have the following tests before your alcohol septal ablation:

  • Chest X-ray.

  • Blood tests.

  • Echocardiogram.

  • Electrocardiogram (EKG).

These tests will help your healthcare provider know what your heart looks like. Testing also may detect other potential conditions that can affect the procedure.

What should I expect during my alcohol septal ablations?

The procedure may take one to two hours or more, depending on your case. It is usually done in a cardiac catheterization lab. A heart doctor and a special team of nurses and technicians will do the ablation.

During the procedure:

  • You will be awake.

  • The team may give you medicine to help you relax.

  • The team may give you aspirin and heparin to reduce the likelihood of blood clots.

  • The groin area where the catheter will be inserted may need to be shaved. A local anesthetic (numbing medicine) is applied to your skin, and a small incision is made.

  • Your doctor will insert a small, flexible tube (catheter) into an artery or vein in your groin.

  • The doctor will thread the tube through your blood vessels all the way to your heart.

  • Your doctor may use angiography, along with a special type of echocardiogram, to make sure the catheter is in the right place.

  • A small amount of pure alcohol is released into an artery in your septum. This destroys part of the septum muscle. This may feel uncomfortable.

  • Your healthcare provider will take measurements of the pressure in your heart to ensure it has improved.

  • The team will remove the tubes through your groin.

  • The team will close and bandage the site where they inserted the tubes.

After the procedure:

  • You will spend several hours in a recovery room.

  • The team will monitor your vital signs.

  • The team may do an echocardiogram to see how successful the ablation was.

  • You will need to lie flat for several hours after the procedure. Avoid bending your legs.

  • Your healthcare provider might prescribe medicines that keep your blood from clotting (anticoagulants).

  • You will probably stay in the cardiac intensive care unit for observation for one to three days.

  • If you have a heart rhythm problem called heart block, you may need to have a permanent pacemaker placed.

  • You can expect to spend about three days or more in the hospital.

How do I care for myself after my alcohol septal ablations?

Most people who have an alcohol septal ablation note immediate improvement of their symptoms.

After you leave the hospital, it is important to follow all the healthcare provider's instructions for medicines, exercise, diet, and wound care. Be sure to keep all your follow-up appointments.