PMID- 35694661
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2297-055X (Print)
IS  - 2297-055X (Electronic)
IS  - 2297-055X (Linking)
VI  - 9
DP  - 2022
TI  - Alcohol Septal Ablation or Septal Myectomy? An Updated Systematic Review and 
      Meta-Analysis of Septal Reduction Therapy for Hypertrophic Obstructive 
      Cardiomyopathy.
PG  - 900469
LID - 10.3389/fcvm.2022.900469 [doi]
LID - 900469
AB  - OBJECTIVE: To evaluate the safety and effectiveness of alcohol septal ablation 
      (ASA) and septal myectomy (SM) for the treatment of hypertrophic obstructive 
      cardiomyopathy. METHODS: We searched the PubMed, MEDLINE, EMBASE, and CBM 
      databases for observational research articles related to ASA and SM published 
      from the establishment of the databases to November 2021. All ultimate selected 
      articles were highly related to our target. The Newcastle-Ottawa Scale was used 
      to evaluate the literature quality. A fixed or random effect model was performed 
      in the meta-analysis depending on the heterogeneity of the included studies. The 
      Mantel-Haenszelt test with relative risk ratio (RR) and 95% confidence interval 
      (CI) was used to measure the effect indicator of binary data, while the inverse 
      variance method with weighted mean difference (WMD) and 95% CI was used to 
      measure the effect indicator of continuous data. RESULTS: A totally of 3,647 
      cases (1,555 cases treated with ASA and 2,092 cases treated with SM) were 
      included. The results of the systematic review indicated no statistically 
      significant difference in postoperative all-cause mortality (RR = 0.82; 95% CI: 
      0.65-1.04; P = 0.10) between patients treated with ASA and SM, but both the 
      reduction in the postoperative left ventricular outflow tract pressure gradient 
      (WMD = 9.35 mmHg, 95% CI: 5.38-13.31, P < 0.00001) and the post-operative 
      improvement on cardiac function, assessed by the grade of New York Heart 
      Association (NYHA), compared to pre-operative measurements (WMD = 0.13; 95% CI: 
      0.00-0.26; P < 0.04) in the ASA group were slightly inferior to those in the SM 
      group. In addition, both the risk of pacemaker implantation (RR = 2.83, 95% CI: 
      2.06-3.88; P < 0.00001) and the risk of reoperation (RR = 11.23, 95% CI: 
      6.21-20.31; P < 0.00001) are recorded at a higher level after ASA procedure. 
      CONCLUSION: Both ASA and SM have a high degree of safety, but the reduction in 
      the postoperative left ventricular outflow tract pressure gradient and the 
      improvement on cardiac function are slightly inferior to SM. In addition, both 
      the risk of pacemaker implantation and the risk of reoperation are recorded at a 
      higher level after ASA procedure. The operative plan should be chosen through 
      multidisciplinary discussions in combination with the wishes of the patients and 
      the actual clinical situation.
CI  - Copyright (c) 2022 Zheng, Yang, Hui, Lu and Feng.
FAU - Zheng, Xifeng
AU  - Zheng X
AD  - Department of Geriatrics, Affiliated Hospital of Guangdong Medical University, 
      Zhanjiang, China.
FAU - Yang, Bin
AU  - Yang B
AD  - Department of Geriatrics, Affiliated Hospital of Guangdong Medical University, 
      Zhanjiang, China.
FAU - Hui, Haosheng
AU  - Hui H
AD  - Department of Cardiology, Affiliated Hospital of Guangdong Medical University, 
      Zhanjiang, China.
FAU - Lu, Bing
AU  - Lu B
AD  - Department of Geriatrics, Affiliated Hospital of Guangdong Medical University, 
      Zhanjiang, China.
FAU - Feng, Yinhui
AU  - Feng Y
AD  - Department of Nuclear Medicine, Affiliated Hospital of Guangdong Medical 
      University, Zhanjiang, China.
LA  - eng
PT  - Systematic Review
DEP - 20220525
PL  - Switzerland
TA  - Front Cardiovasc Med
JT  - Frontiers in cardiovascular medicine
JID - 101653388
PMC - PMC9178179
OTO - NOTNLM
OT  - alcohol septal ablation
OT  - hypertrophic obstructive cardiomyopathy
OT  - meta-analysis
OT  - septal myectomy
OT  - systematic review
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/06/14 06:00
MHDA- 2022/06/14 06:01
PMCR- 2022/01/01
CRDT- 2022/06/13 03:35
PHST- 2022/03/20 00:00 [received]
PHST- 2022/04/11 00:00 [accepted]
PHST- 2022/06/13 03:35 [entrez]
PHST- 2022/06/14 06:00 [pubmed]
PHST- 2022/06/14 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fcvm.2022.900469 [doi]
PST - epublish
SO  - Front Cardiovasc Med. 2022 May 25;9:900469. doi: 10.3389/fcvm.2022.900469. 
      eCollection 2022.