Transcoronary ablation of septal hypertrophy (abbreviated to TASH) is an invasive cardiologic procedure. This treatment is used for hypertrophic obstructive cardiomyopathy (HOCM). The aim of this procedure is to eliminate the hypertrophy or alleviate the symptoms in the long term.
Here you will find further information as well as selected specialists and centers for TASH treatment.
Treatment options in the field of cardiology have improved significantly in recent decades.
Patients with hypertrophic obstructive cardiomyopathy(HOCM) also benefit from this. This disease leads to a pathologically thickened heart muscle. The patient then suffers from chest tightness and shortness of breath, both at rest and during exercise. The disease cannot be cured, but relief can be achieved with the help of TASH treatment.
The basic idea behind TASH is to obliterate the troublesome heart muscle using ethanol, i.e. high doses of alcohol. This procedure was first used successfully in 1995. Since then, heart surgery has rarely been used for hypertrophic obstructive cardiomyopathy.
Sclerotherapy of the thickened heart muscle as part of TASH is performed during cardiac catheterization. The catheter is inserted into the coronary arteries. There, the doctor injects approx. 1 ml of alcohol into the affected area. This closes off small vessels that the heart does not need.
As a result, the thickened area is no longer supplied with blood so that the blood flow in the heart can flow unhindered again.
The aim of TASH treatment is to restore the patient's physical performance. They should then be able to perform their everyday tasks at an average level of exertion.
The success of the treatment can be recognized by a reduction or even complete elimination of the symptoms. A corresponding result can be achieved in around 90 percent of patients who have undergone TASH treatment. Many patients describe a feeling of relief and a reduction in breathlessness in the first few days after treatment.
TASH treatment can be used if previous medical treatment has not been successful. Most patients with HOCM requiring treatment undergo this therapy.
Hypertensive (obstructive) cardiomyopathy is a common reason for TASH treatment © Akarat Phasura | AdobeStock
TASH treatment is not possible for all patients. It does not always lead to success. An alternative is heart surgery, a so-called myectomy. It is also used if there is additional damage to the heart.
Possible accompanying diseases include
During a myectomy, the troublesome bulge on the heart muscle is removed from the open chest under general anesthesia. The heart chamber is not opened. Instead, the surgeon inserts the cutting tool through the heart valve into the ventricle to remove the thickened heart muscle. The risk for the patient is higher with a myectomy than with TASH treatment.
The disruptive bulge in the heart muscle is located in a sensitive area of the heart. The pathways for the electrical stimulation of the heart muscle cells to beat the heart run through this area. TASH treatment can therefore lead to their dysfunction. This will lead to a missing or at least permanently slowed heartbeat.
As a precautionary measure, the patient is therefore often given a pacemaker for a few hours immediately after the procedure. In rare cases, a permanent pacemaker has to be implanted afterwards.
Like a myectomy, TASH treatment is only carried out by experienced cardiac surgeons in particularly specialized cardiology centers. Both treatment methods are considered to be very effective in alleviating and completely eliminating the symptoms of HOCM.
No rehabilitation is usually necessary following TASH treatment. The procedure is not very stressful. The patient should take it easy for a while after the hospital stay. A period of around two weeks is usually recommended.
After this, the patient may exercise as much as their well-being allows.
Athletes in particular who have trained at a competitive level must exercise restraint, even if they feel perfectly healthy.
However, there is nothing wrong with regular physical exercise. Doctors even expressly recommend that patients after TASH treatment get enough exercise. Exercise has a positive effect on the regulation of the circulation. This also reduces the risk of a heart attack.
Particularly recommended are activities such as
sports with fluid movements.
After successful TASH treatment, many patients can significantly reduce the number of medications they need. Some medications, such as beta blockers, can even be dispensed with completely.
Patients with hypertrophic obstructive cardiomyopathy already suffer from reduced cardiac performance. They should therefore reduce all risk factors that could lead to further heart disease. This requires, for example, a balanced and healthy diet, as well as avoiding cigarettes and excessive stress.
Both TASH treatment and open heart surgery are effective in the long term. Patients with HOCM experience significant relief of their symptoms with TASH treatment. The typical symptoms of the disease can be greatly reduced or completely eliminated in the long term.
In addition, serious cardiac arrhythmias can be avoided with TASH treatment. There is also evidence that TASH treatment has a positive impact on life expectancy in patients with severe HOCM.
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