Treatment Modalities in Hypertrophic Obstructive Cardiomyopathy: Surgical Myectomy versus Percutaneous Septal Ablation

Abstract

The 2 approaches yielded similar results with regard to reducing the LVOT gradient. We conclude that SM is preferable to PSMA in cases with MR.

Updated Meta-Analysis of Septal Alcohol Ablation Versus Myectomy for Hypertrophic Cardiomyopathy

“…Ralph-Edwards et al (9) reported a significantly higher post-procedure SAM in patients undergoing SA than those undergoing SM (OR: 4.8; 95% CI: 2.0 to 11.9). No significant differences in SAM occurrence were encountered in other studies (10,11,14).…”

“…Two studies (13,15) reported a significantly higher LBBB after myectomy, compared with after ablation. On the contrary, Vural et al (11) reported higher LBBB in the SA group. A pooled estimate/meta-analysis was deemed fallacious in this case.…”

“…The MR and SAM have been quantified differently across studies. No study (8,9,11) reported a significant difference in the occurrence of post-procedure moderate-severe MR between the 2 groups. The pooled OR was statistically insignificant (1.44, 95% CI: 0.6 to 3.5).…”

“…No significant difference was observed in the reintervention rate between the 2 strategies (pooled OR: 2.37; 95% CI: 0.54 to 10.5; p ϭ 0.3). Pooled estimates were not calculated for length of hospital stay, due to differences in quantification of length of hospital stay across studies (9,11,14). Two studies reported shorter hospital stay in the SA group, compared with the SM group (11,14).…”

“…Pooled estimates were not calculated for length of hospital stay, due to differences in quantification of length of hospital stay across studies (9,11,14). Two studies reported shorter hospital stay in the SA group, compared with the SM group (11,14). However, Ralph-Edwards et al (9) reported that mean hospital stay was 4.1 days longer among the SA group patients, compared with SM group patients.…”