Cardiomyopathy surgery
Cardiomyopathy Microchapters |
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2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Surgery
Doctors use several types of surgery to treat cardiomyopathy. They include septal myectomy (mi-EK-toe-me), implanted devices to help the heart work better, and heart transplant.
Septal Myectomy
Septal myectomy is open-heart surgery. It's used for people 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, a 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 you to return to a normal life with no symptoms.
Surgically Implanted Devices
Surgeons can place several types of devices 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 your 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
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. For more information about this treatment, go to the Diseases and Conditions Index Heart Failure article.
Nonsurgical Procedure
Doctors may use a nonsurgical procedure called alcohol septal ablation to treat cardiomyopathy. For this procedure, your 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.
This procedure allows blood to flow freely through the ventricle, which improves symptoms.