• Daokun Sun, Hartzell V Schaff, Holly K Van Houten, Anita Nguyen, Lindsey R Sangaralingham, Rick A Nishimura, Jeffrey B Geske, Joseph A Dearani, and Steve R Ommen.
• Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN.
• Mayo Clin. Proc. 2022 Sep 1; 97 (9): 1656-1663.

ObjectiveTo compare the postprocedural health care utilization and cost of septal myectomy (SM) and alcohol septal ablation (ASA).Patients And MethodsUsing the OptumLabs Data Warehouse, we analyzed de-identified claims data of adult patients undergoing SM and ASA for obstructive hypertrophic cardiomyopathy from January 1, 2006, through December 31, 2018. We used propensity score weighting to compare the 2-year incidence rates of emergency department visits and rehospitalizations after SM and ASA.ResultsWe identified 953 patients in total: 660 underwent SM and 293 underwent ASA. There was no difference in the risk (odds ratio, 1.1; 95% CI, 0.6 to 1.8) or frequency (incidence rate ratio, 1.1; 95% CI, 0.8 to 1.5) of emergency department visits, but the annual risk of hospital readmission was 10.8% after SM and 25.9% after ASA during the second postoperative year (P=.004). In those who were ever readmitted, the average length of hospital stay within the first 2 years after ASA was 1.6 times as long as that after SM (incidence rate ratio, 1.6; 95% CI, 1.0 to 2.4). Overall, the 2-year cumulative postprocedural cost was significantly higher after ASA (P<.001).ConclusionCompared with ASA, SM is associated with fewer hospital readmissions and lower 2-year postprocedural health care cost.Copyright © 2022 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

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