Non-surgical reduction of myocardial septum (IPG40)
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on non-surgical reduction of myocardial septum.
This procedure is used to treat hypertrophic obstructive cardiomyopathy.
People with hypertrophic obstructive cardiomyopathy (HOCM) have abnormally thickened heart muscle. Thickening is usually most severe in the wall (septum) between the right and left ventricles and may cause obstruction to the flow of blood out of the left ventricle.
HOCM may cause chest pain, breathlessness, palpitations and syncope. People with HOCM have an increased risk of sudden death from heart attacks or abnormal heart rhythms.Most people with HOCM are treated with medication. More invasive treatments may be considered in people who still get symptoms despite drug treatment.
The standard surgical treatment is ventricular septal myotomy-myectomy. This is an open surgical technique that requires cardiopulmonary bypass. A small amount of muscle is removed from the septum to reduce its thickness and reduce obstruction.
Non-surgical ablation of the septum does not require open heart surgery or cardiopulmonary bypass. It involves inserting a catheter into the femoral artery and passing it up into the heart under X-ray control. Alcohol is injected into an artery supplying blood to the septum. This destroys a part of the septal muscle which then becomes thinner.
K16.6 Percutaneous transluminal chemical mediated septal ablation
Y53.- Approach to organ under image control
Note: Codes within category Y53.- are used as secondary codes to classify interventions that are percutaneous and require some form of image control: if the method of image control is unspecified, Y53.9 Unspecified approach to organ under image control is assigned.
The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS. The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. www.connectingforhealth.co.uk/clinicalcoding
- IPG40 Non-surgical reduction of myocardial septum: guidance (web format)
- IPG040, Non-surgical reduction of myocardial septum - guidance
- IPG040 Non-surgical reduction of myocardial septum - information for people considering the procedure, and for the public
- IPG040, Non-surgical reduction of myocardial septum, distribution list
- Interventional Procedures Consultation Document - Non-surgical reduction of myocardial septum
- Overview of non-surgical ablation of septum in hypertrophic obstructive cardiomyopathy
This page was last updated: 15 June 2012
Information for the public
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The summary of the key recommendations in the guidance written for patients, carers and those with little medical knowledge and may be used in local patient information leaflets.
Quick Reference Guide
The quick reference guide presents recommendations for health professionals
The published NICE clinical guidance, contains the recommendations for health professionals and NHS bodies.
The published full clinical guidance for specialists with background, evidence, recommendations and methods used.