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

Abstract

SA does seem to show promise in treatment of HOCM owing to similar mortality rates as well as functional status compared with SM; however, the caveat is increased conduction abnormalities and a higher post-intervention LVOTG. The choice of treatment strategy should be made after a thorough discussion of the procedures with the individual patient.

Survival after alcohol septal ablation versus conservative therapy in obstructive hypertrophic cardiomyopathy

“…However, we are still not sure whether this technique extends longevity of its target patients. Results from several studies suggest that ASA can extend longevity of patients with HCM [6][7][8][9][10][11][12]. Here, we extended evidence for this notion by directly comparing the survival of patients undergoing ASA vs. a group of conservatively treated patients with comparable pressure gradient and limiting symptoms.…”

“…Studies have demonstrated that survival rates after ASA and myectomy in experienced centers were similar [6][7][8]. And, as survival after myectomy, survival after ASA is also comparable with that of general population [8,9].…”

Alcohol septal ablation in obstructive hypertrophic cardiomyopathy: Four years of experience at a reference center

“…Clinical outcomes are similar to those of myectomy, as shown in two recent meta-analyses, in which the only difference was the need for permanent pacing. 30,31 These results reflect the learning curve required for ASA, as was initially seen for myectomy, although not in recent publications.…”

Optimal gradient reduction after alcohol septal ablation: a case report with anatomical and practical determinants

“…After the introduction of MCE, the outcome improved and complications were reduced [4,5]. Despite these techniques, gradient reduction after ASA remains slightly less compared with surgical myectomy [1,2]. This may be important since higher outflow gradients after ASA are associated with a less favourable long-term haemodynamic outcome [6].…”

“…However, gradient reduction after ASA was slightly less favourable [1,2] and in a singlecentre study a higher rate of aborted sudden cardiac death was found [3]. The following case report illustrates the importance of coronary anatomy and infarction location in determining the outcome after ASA.…”