SynthesisFrontiers in surgery2025
Comparison of morrow procedure and transapical beating-heart septal myectomy in patients with hypertrophic obstructive cardiomyopathy: a systematic review and meta-analysis.
Synthesis in Frontiers in surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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4 authors.
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Abstract
Introduction: Transaortic surgical myectomy is the established gold-standard treatment for hypertrophic obstructive cardiomyopathy (HOCM). In contrast, the less invasive transapical beating-heart septal myectomy (TABSM) has recently gained attention as a potential alternative, although comparative evidence regarding their clinical outcomes remains limited. Objectives: To compare the efficacy and safety of surgical myectomy and TABSM in patients with HOCM. Methods: A systematic search of PubMed, Web of Science, Cochrane Library, and ScienceDirect (January 2014-May 2025) identified 24 observational studies including 3,732 patients (2,824 surgical myectomy; 908 TABSM). The primary outcome was the change in left ventricular outflow tract pressure gradient (LVOTPG). Secondary outcomes included improvement in NYHA class, prevalence of moderate-to-severe mitral regurgitation (MR ≥ 2), short-term (30-day) and long-term mortality, and the rate of postoperative permanent pacemaker implantation. Random-effects meta-analysis and meta-regression were performed. Results: Both procedures achieved substantial and comparable reductions in LVOTG, with no significant between-group difference ( Conclusion: Both surgical myectomy and TABSM are effective and safe approaches for septal reduction in HOCM. While surgical myectomy remains the reference standard, TABSM represents a promising minimally invasive option, particularly in anatomically complex or reoperative cases. Prospective studies with standardized endpoints are required to guide individualized procedural selection and confirm long-term outcomes. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251075522, Identifier CRD420251075522.
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