JUAN CRESTANELLO: You're advising a patient who has hypertrophic obstructive cardiomyopathy on the benefits of two different septal reduction strategies: alcohol septal ablation or surgical septal myectomy. I am Dr. Juan Crestanello. Welcome to the Cardiovascular Surgery Series where I review the latest research in cardiovascular surgery from the Mayo Clinic in just two minutes.

This article will answer your question. I will review survival following alcohol septal ablation or septal myectomy for patients with obstructive hypertrophic cardiomyopathy.

In this multicenter study, researchers from our institution evaluated almost 4,000 patients who had either septal myectomy or alcohol septal ablation. Fifteen percent of the patients had alcohol septal ablation and 85% had septal myectomy.

Patients who had alcohol septal ablation were older and had more comorbidities. Procedure mortality was lower for septal myectomy. Long-term mortality either adjusted or unadjusted was lower for septal myectomy done for alcohol septal ablation.

The survival benefit of septal myectomy was evident after three years. The increased risk of death for alcohol septal ablation over septal myectomy is seen across age, septal thickness, LVOT gradient, and gender.

The risk of death for alcohol septal ablation was even greater for patients who were in lower association functional class four.

We conclude that alcohol septal ablation is associated with increased long-term all-cause mortality. This impact on survival is independent of other clinical and echocardiographic variables. Thank you for listening to the Mayo Clinic Cardiovascular Surgery Series.