title: Comparison of percutaneous transluminal septal myocardial ablation versus septal myectomy for the treatment of patients with hypertrophic obstructive cardiomyopathy--a meta analysis.
abstract: BACKGROUND
  The effects of percutaneous transluminal septal myocardial ablation (PTSMA) with septal myectomy in patients with hypertrophic obstructive cardiomyopathy (HOCM) are not thoroughly compared.
  
  
  METHODS
  Three articles comparing the effects of PTSMA and septal myectomy treatment for HOCM were identified from a search in Pubmed, and a meta analysis was conducted.
  
  
  RESULTS
  177 patients (86 underwent PTSMA and 91 underwent septal myectomy) were included. Interventricular septum thickness was decreased from 22.1 to 15.1 mm (p<0.05) in PTSMA group and from 22.0 to 13.9 mm (p<0.05) in septal myectomy group; left ventricular end-diastolic dimension was increased from 41.8 to 45.2 mm (p<0.05) in PTSMA group and from 41.8 to 43.9 mm (p<0.05) in septal myectomy group; NYHA class was improved from 3.17 to 1.47 (p<0.05) in PTSMA group and from 2.97 to 1.36 (p<0.05) in septal myectomy group; there were no differences in the two groups. However, left ventricular outflow tract gradient was decreased from 76.0 to 15.7 mm Hg (p<0.05) in PTSMA group and from 74.7 to 9.4 mm Hg (p<0.05) in septal myectomy group and the effect of septal myectomy was better than PTSMA (p<0.05).
  
  
  CONCLUSIONS
  The effects of septal myectomy treatment for HOCM are better with regard to relief of LVOT gradient, and lower risk of pacemaker requirement, compared to PTSMA. Large randomized clinical trials further comparing the two treatments are suggested.
authors.affiliation: Center for Arrhythmia Diagnosis and Treatment, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. zsfuwai@vip.163.com
authors.forename: Zhiyu
authors.initials: Z
authors.lastname: Zeng
authors.forename: Fangzheng
authors.initials: F
authors.lastname: Wang
authors.forename: Xiangfeng
authors.initials: X
authors.lastname: Dou
authors.forename: Shu
authors.initials: S
authors.lastname: Zhang
authors.forename: Jielin
authors.initials: J
authors.lastname: Pu
mesh_terms: D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods; D004452:Echocardiography; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D016896:Treatment Outcome