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Septal Myectomy in Pediatric Obstructive Hypertrophic Cardiomyopathy: A Systematic Review and Meta-analysis

Anelise Poluboiarinov Cappellaro1, Luiz Felipe Costa de Almeida2, Ronaldo Altenburg Odebrecht Curi Gismondi3

  • 1Centro Universitário Maurício de Nassau de Barreiras, Barreiras, Brazil.

Pediatric Cardiology
|November 17, 2025
PubMed

Insights

Septal myectomy is a safe and effective surgery for children with obstructive hypertrophic cardiomyopathy (HOCM), significantly improving symptoms and heart function. Long-term survival is favorable, though data quality requires cautious interpretation.

Area of Science:

  • Cardiology
  • Pediatric Surgery
  • Medical Outcomes Research

Background:

  • Obstructive hypertrophic cardiomyopathy (HOCM) in children presents unique challenges.
  • Limited evidence exists on the outcomes of surgical intervention for pediatric HOCM.

Purpose of the Study:

  • To assess the surgical outcomes and long-term survival rates of pediatric patients undergoing septal myectomy for HOCM.
  • To evaluate the hemodynamic and symptomatic improvements following the procedure.

Main Methods:

  • A systematic review and meta-analysis of published clinical trials.
  • Inclusion criteria focused on pediatric patients with obstructive HOCM undergoing septal myectomy.
  • Data synthesis from eight trials involving 490 patients.

Main Results:

  • Pooled early and late mortality rates were 3.3% and 8.5%, respectively.
  • Significant reduction in left ventricular outflow tract (LVOT) gradient (86.9 to 16.2 mmHg) and mitral regurgitation (49.8% to 6.4%).
  • Low rates of complications such as complete atrioventricular block (9.9%) and permanent pacemaker implantation (5.1%).

Conclusions:

  • Septal myectomy is a safe and effective treatment for pediatric obstructive HOCM.
  • The procedure leads to favorable survival and substantial hemodynamic and symptomatic improvement.
  • Findings are based on moderate-quality retrospective data, necessitating cautious interpretation.

Keywords:
ChildrenObstructive hypertrophic cardiomyopathyPediatricSeptal myectomy

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