ࡱ> )+*q` 0bjbjqPqP 1::$$8  $v $, h   0  `V&yF 0v  g^  0  v $$$$$$$$$ ALCOHOL SEPTAL ABLATION AND SEPTAL MYOMECTOMY FOR HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY: A META-ANALYSIS M. Alam, H. Dokainish, N.M. Lakkis Baylor College of Medicine, Department of Medicine - Section of Cardiology, Houston, TX, USA Alcohol Septal Ablation (ASA) is a less invasive alternative to myomectomy (MM) for relief of symptoms in patients with drug refractory hypertrophic obstructive cardiomyopathy (HOCM). We conducted a meta-analysis of published studies comparing the outcome of patients undergoing these procedures. Methods: An extensive search of pubmed identified 5 studies (351 patients, no randomized trials) comparing the outcomes of patients undergoing ASA and MM. All included studies were tested for heterogeneity (Q,H and I2 statistics) and meta-analysis was performed using fixed-effect ratio model. A p value of<0.05 was considered significant. Results: Of 351 patients, 183 underwent ASA and 168 underwent MM (mean follow-up 21.719.4 and 25.422.0 months for ASA and MM respectively). Patients undergoing ASA were older (mean age 54.46.3 vs. 45.04.4 years,p=0.02). All patients were in NYHA class III-IV. Baseline left ventricular outflow tract (LVOT) gradient was comparable (81.4 14.3mmHg in ASA vs. 77.415.5mmHg in MM,p=0.2). Although resting LVOT gradient in both groups was<20mmHg at follow-up, patients undergoing MM had lower LVOT gradient (18.26.7mmHg vs. 10.86.3mmHg,p<0.001). A higher percentage of patients undergoing ASA required permanent pacemaker(PPM) implantation for complete heart block(18.47.9 vs. 3.33.9%,p=0.04). Patients in the two groups had comparable improvement in NYHA class(1.50.3 in ASA vs. 1.30.2,p=0.2) at follow-up. A cardiac mortality rate of 1.42.1% was described in patients with ASA compared to 0.0% in MM(p=0.2). Conclusions: ASA and MM provide comparative reduction in NYHA class and a sustained LVOT gradient reduction on a medium term follow-up.A higher percentage of patients require permanent pacemaker placement after ASA.     1258, either, cat: 34 klmnsvw۷hmjhmUh!B*phP8 h* JB*phh!B*phh$Yh$Yh$Y5>*\h$Yh$5>*\h! h!5\l $1$7$8$H$a$1$7$8$H$/0P/ =!"#$% @@@ NormalCJ_H aJmH sH tH DA@D Default Paragraph FontRi@R  Table Normal4 l4a (k@(No List 4@4 $YHeader  !4 @4 $YFooter  !l000000I0I0I0I0@0I0D #####&  8@0(  B S  ?osx-7u6<;B@Bdj3333333/{D* J$Y$!m@He0@UnknownGz Times New Roman5Symbol3& z Arial"h^fbfVf,,$xx2?!2kALCOHOL SEPTAL ABLATION AND SEPTAL MYOMECTOMY FOR HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY: A META-ANALYSIS RamitargetOh+'0 0<HX ht    lALCOHOL SEPTAL ABLATION AND SEPTAL MYOMECTOMY FOR HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY: A META-ANALYSIS RamiNormaltarget3Microsoft Office Word@^в@\)qy@Cy@Py,՜.+,0\ hp  < Atartica lALCOHOL SEPTAL ABLATION AND SEPTAL MYOMECTOMY FOR HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY: A META-ANALYSIS Title  !"#&Root Entry Fu&y(1Table WordDocument1SummaryInformation(DocumentSummaryInformation8CompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89qRoot Entry F .1Table WordDocument1SummaryInformation( -, Title4 $, DocumentSummaryInformation8CompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89q՜.+,D՜.+,\ hp  < Atartica lALCOHOL SEPTAL ABLATION AND SEPTAL MYOMECTOMY FOR HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY: A META-ANALYSIS