Association between hospital volume, clinical events, resource utilization, and costs of septal myectomy and alcohol septal ablation procedures in US patients with hypertrophic cardiomyopathy

Abstract Background Prior studies have evaluated the relationship between hospital procedural volumes of septal reduction therapies (SRT) for obstructive hypertrophic cardiomyopathy (HCM) and outcomes. Other analyses, including economic outcomes, are needed to support clinical decisions among adult patients diagnosed with HCM. Objective The objective of this study was to reconfirm the relationship between higher SRT procedural volume, including septal myectomy (SM) -with and without mitral valve repair or replacement (MVRR)- and alcohol septal ablation (ASA), and clinical events, healthcare resource utilization, and hospitalization costs using more contemporary hospitalization data. Data for SM, 5.1%, 3.4% and 2.9%, respectively (not statistically different). For ASA and SM, index hospital costs, and 30-day readmission rates had an inverse relationship to hospital volume, with statistically significant differences for both procedures between the low- and high-volume hospitals (p0.05). Conclusion The annual number of SRT procedures for obstructive HCM remains low, even for higher volume hospitals. This study shows high variability in clinical events, resource utilization, and in-hospital costs by hospital procedure volume and type of SRT. We reconfirmed that higher hospital procedure volume is associated with fewer adverse clinical events and lower costs.