{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T15:42:35Z","timestamp":1792078955190,"version":"4.4.0"},"reference-count":64,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T00:00:00Z","timestamp":1676332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p\/><jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>To elucidate the optimal septal reduction therapy for obstructive hypertrophic cardiomyopathy, we conducted a meta-analysis comparing alcohol septal ablation (ASA) and septal myectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>MEDLINE, EMBASE and Cochrane CENTRAL were searched to identify studies investigating the outcomes of ASA and septal myectomy in patients with obstructive hypertrophic cardiomyopathy in January 2023. The primary outcome of interest was all-cause mortality in studies with \u22651\u2009year of follow-up. The secondary outcomes of interest comprised left ventricular outflow tract (LVOT) pressure gradient reduction and reoperations of LVOT. A subgroup analysis of all-cause mortality including studies with follow-up \u22655\u2009years was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>27 observational studies were included (15\u200a968 patients). Analysis demonstrated similar all-cause mortality [hazard ratio (HR) (95% confidence interval) (CI) 1.24 (0.88\u20131.76); P\u2009=\u20090.21; I2\u2009=\u200956%]. In contrast, ASA was associated with less reduction of LVOT pressure gradient and a reoperation rate [weighted mean difference (95% CI) 11.04\u2009mmHg (5.60\u201316.48); P\u2009&amp;lt;\u20090.01; I2\u2009=\u200964%, HR (95% CI) 9.14 (6.55\u201312.75); P\u2009&amp;lt;\u20090.001; I2\u2009=\u20090%, respectively]. The subgroup analysis with follow-up \u22655\u2009years revealed higher long-term mortality with ASA [HR (95% CI) 1.50 (1.04\u20132.15); P\u2009=\u20090.03; I2\u2009=\u200952%].<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Although both septal reduction therapies were associated with similar all-cause mortality, ASA was associated with a higher rate of reoperation and less reduction of LVOT pressure gradient. Furthermore, all-cause mortality with follow-up \u22655\u2009years showed favourable outcomes with septal myectomy, although the result is only hypothesis-generating given a subgroup analysis.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ejcts\/ezad043","type":"journal-article","created":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T05:17:57Z","timestamp":1676351877000},"source":"Crossref","is-referenced-by-count":29,"title":["Alcohol septal ablation versus surgical septal myectomy of obstructive hypertrophic cardiomyopathy: systematic review and meta-analysis"],"prefix":"10.1093","volume":"63","author":[{"given":"Yujiro","family":"Yokoyama","sequence":"first","affiliation":[{"name":"Department of Surgery, St. Luke\u2019s University Health Network , Bethlehem, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5092-3127","authenticated-orcid":false,"given":"Tomonari","family":"Shimoda","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Tsukuba , Ibaraki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi J","family":"Shimada","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center , New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichi","family":"Shimamura","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, Emory University , Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5395-1887","authenticated-orcid":false,"given":"Keitaro","family":"Akita","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center , New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risako","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center , New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroo","family":"Takayama","sequence":"additional","affiliation":[{"name":"Department of Surgery, Columbia University Irving Medical Center , New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2487-8366","authenticated-orcid":false,"given":"Toshiki","family":"Kuno","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,2,14]]},"reference":[{"key":"2023032317284938900_","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1161\/01.CIR.92.4.785","article-title":"Prevalence of hypertrophic cardiomyopathy in a general population of young adults. 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