{"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":1792078955195,"version":"4.4.0"},"reference-count":45,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T00:00:00Z","timestamp":1600819200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Surgical myectomy (SM) and alcohol septal ablation (ASA) are two invasive therapies for symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM), despite medical therapy. This meta-analysis aims to compare the efficacy of the two procedures. We searched all electronic databases until February 2020 for clinical trials and cohorts comparing clinical outcomes of ASA and SM treatment of patients with HOCM. The primary endpoint was all-cause mortality, cardiovascular (CV) mortality, sudden cardiac death (SCD), re-intervention, and complications. Secondary endpoints included relief of clinical symptoms and drop of left ventricular outflow tract (LVOT) gradient. Twenty studies (4547 patients; 2 CTs and 18 cohorts) comparing ASA vs. SM with a mean follow-up of 47 \u00b1 28.7 months were included. Long term (8.72 vs. 7.84%, p = 0.42) and short term (1.12 vs. 1.27%, p = 0.93) all-cause mortality, CV mortality (2.48 vs. 3.66%, p = 0.26), SCD (1.78 vs. 0.76%, p = 0.20) and stroke (0.36 vs. 1.01%, p = 0.64) were not different between procedures. ASA was associated with lower peri-procedural complications (5.57 vs. 10.5%, p = 0.04) but higher rate of re-interventions (10.1 vs. 0.27%; p &lt; 0.001) and pacemaker dependency (12.4 vs. 4.31%, p = 0.0004) compared to SM. ASA resulted in less reduction in LVOT gradient (\u221247.8 vs. \u221258.4 mmHg, p = 0.01) and less improvement of clinical symptoms compared to SM (New York Heart Association (NYHA) class III\/IV, 82.4 vs. 94.5%, p &lt; 0.001, angina 53.2 vs. 84.2%, p = 0.02). Thus, ASA and SM treatment of HOCM carry a similar risk of mortality. Peri-procedural complications are less in alcohol ablation but re-intervention and pacemaker implantations are more common. These results might impact the procedure choice in individual patients, for the best clinical outcome.<\/jats:p>","DOI":"10.3390\/jcm9103062","type":"journal-article","created":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T02:56:43Z","timestamp":1600916203000},"page":"3062","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Alcohol Septal Ablation versus Septal Myectomy Treatment of Obstructive Hypertrophic Cardiomyopathy: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8996-4257","authenticated-orcid":false,"given":"Ibadete","family":"Byty\u00e7i","sequence":"first","affiliation":[{"name":"Institute of Public Health and Clinical Medicine, Ume\u00e5 University, 90187 Ume\u00e5, Sweden"},{"name":"Universi College, Bardhosh, 10000 Prishtina, Kosovo"},{"name":"Clinic of Cardiology, University Clinical Centre of Kosovo, 10000 Prishtina, Kosovo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Nistri","sequence":"additional","affiliation":[{"name":"Cardiology Service, CMSR-Veneto Medica, 204-36077 Altavilla Vicentina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stellan","family":"M\u00f6rner","sequence":"additional","affiliation":[{"name":"Institute of Public Health and Clinical Medicine, Ume\u00e5 University, 90187 Ume\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Y.","family":"Henein","sequence":"additional","affiliation":[{"name":"Institute of Public Health and Clinical Medicine, Ume\u00e5 University, 90187 Ume\u00e5, Sweden"},{"name":"Molecular and Clinic Research Institute, St George University, Brunel University, London SW17 0QT, UK"},{"name":"Institute of Fluid Dynamics, Brunel University, London UB8 3PH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1016\/S0140-6736(16)31321-6","article-title":"Hypertrophic obstructive cardiomyopathy","volume":"389","author":"Veselka","year":"2017","journal-title":"Lancet"},{"key":"ref_2","first-page":"373","article-title":"Hypertrophic cardiomyopathy","volume":"381","author":"Chan","year":"2013","journal-title":"Cardiac CT MR Adult Congenit. 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