1. Outcomes following the surgical management of left ventricular outflow tract obstruction; A systematic review and meta-analysis
- Author
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Mohammad Shafiqur Rahman, Richard Collis, Constantinos O'Mahony, Oliver P Guttmann, Oliver Watkinson, and Perry M. Elliott
- Subjects
medicine.medical_specialty ,Heart Ventricles ,Ventricular outflow tract obstruction ,Ventricular Outflow Obstruction ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Mitral valve ,Medicine ,Humans ,030212 general & internal medicine ,Disease management (health) ,Mortality ,business.industry ,Hypertrophic cardiomyopathy ,Disease Management ,medicine.disease ,Septal myectomy ,medicine.anatomical_structure ,Treatment Outcome ,Data extraction ,Meta-analysis ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Left ventricular outflow tract obstruction (LVOTO) causes exertional symptoms in two thirds of patients with hypertrophic cardiomyopathy (HCM). Consensus guidelines recommend surgical intervention in patients with drug refractory symptoms. The primary aim of this study was to perform a systematic review and meta-analysis to determine morbidity and mortality after surgery. Methods Study Selection: Studies reporting outcomes following surgical intervention for symptomatic LVOTO in HCM. Data Extraction: Articles from searching two scientific databases (PubMed and Web of Science) were reviewed and data were extracted by two investigators. Meta-analysis of data was performed with heterogeneity assessed using I2 statistic. Results 85 studies were included in the systematic review and 35 studies in the meta-analysis. Contemporary early ( 30 days) mortality following septal myectomy were 1.4% (CI 0.8, 2.4) I2 9.0%, p = 0.36 and 0.7% (CI 0.3, 1.2) I2 70.7%, p Conclusions Contemporary surgical management of LVOTO is associated with low operative mortality rates but further studies are needed to investigate the impact of surgical therapy on non-fatal early and late complications.
- Published
- 2017