Coronary Bypass Surgery with or without Surgical Ventricular Reconstruction

Jones, Robert H.; Velázquez, Eric J.; Michler, Robert E.; Sopko, George; Oh, Jae K.; O’Connor, Christopher M.; Hill, James A.; Menicanti, Lorenzo; Sadowski, Zygmunt; Desvigne‐Nickens, Patrice; Rouleau, Jean L.; Lee, Kerry L.

doi:10.1056/nejmoa0900559

Cited by 657 publications

(498 citation statements)

References 25 publications

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“…For patients with ischemic heart disease, SVR has yielded beneficial short-term effects on functional status, exercise performance, long-term results, and quality of life 48,49) . However, concomitant SVR is still controversial during CABG for these patients 48,49,50) . Recently, the Surgical Treatment for Ischemic Heart Failure (STICH) trial addressed this question and demonstrated that anatomical change by SVR was not associated with a greater improvement in symptoms or exercise tolerance or with a reduction in the rate of death or hospitalization for cardiac causes 50) .…”

Section: Discussionmentioning

confidence: 99%

“…However, concomitant SVR is still controversial during CABG for these patients 48,49,50) . Recently, the Surgical Treatment for Ischemic Heart Failure (STICH) trial addressed this question and demonstrated that anatomical change by SVR was not associated with a greater improvement in symptoms or exercise tolerance or with a reduction in the rate of death or hospitalization for cardiac causes 50) . Patient selection issues and hemodynamic effects of LV volume reduction have been proposed to explain these contradictory results 50) .…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the Surgical Treatment for Ischemic Heart Failure (STICH) trial addressed this question and demonstrated that anatomical change by SVR was not associated with a greater improvement in symptoms or exercise tolerance or with a reduction in the rate of death or hospitalization for cardiac causes 50) . Patient selection issues and hemodynamic effects of LV volume reduction have been proposed to explain these contradictory results 50) . Thus, it would be very difficult to conclude anything about the efficacies associated with SVR, even though a large, multicenter, randomized trial such as STICH has been done.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical Ventricular Restoration for Ischemic Cardiomyopathy with Functional Mitral Regurgitation

Hirota¹,

Katahira²,

Hoshino³

et al. 2012

Front Lines of Thoracic Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical Ventricular Restoration for Ischemic Cardiomyopathy with Functional Mitral Regurgitation

Hirota¹,

Katahira²,

Hoshino³

et al. 2012

Front Lines of Thoracic Surgery

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“…In a subgroup of 490 patients allocated to SVR in addition to CABG there was no benefit for the patients who had postoperative ESVI greater than 70 mL/m 2 . 141 These and other findings have generated much controversy and discussion.…”

Section: -151mentioning

confidence: 99%

Noninvasive assessment myocardial viability: Current status and future directions

Allman

2013

Journal of Nuclear Cardiology

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Observations of reversibility of cardiac contractile dysfunction in patients with coronary artery disease and ischemia were first made more than 40 years ago. Since that time a wealth of basic science and clinical data has been gathered exploring the mechanisms of this phenomenon of myocardial viability and relevance to clinical care of patients. Advances in cardiac imaging techniques have contributed greatly to knowledge in the area, first with thallium-201 imaging, then later with Tc-99m-based tracers for SPECT imaging and metabolic tracers used in conjunction with positron emission tomography (PET), most commonly F-18 FDG in conjunction with blood flow imaging with N-13 ammonia or Rb-82 Cl. In parallel, stress echocardiography has made great progress also. Over time observational studies in patients using these techniques accumulated and were later summarized in several meta-analyses. More recently, cardiac magnetic resonance imaging (CMR) has contributed further information in combination with either late gadolinium enhancement imaging or dobutamine stress. This review discusses the tracer and CMR imaging techniques, the pooled observational data, the results of clinical trials, and ongoing investigation in the field. It also examines some of the current challenges and issues for researchers and explores the emerging potential of combined PET/CMR imaging for myocardial viability.

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“…Currently clinical trials are evaluating the effectiveness of percutaneous strategies to treat ventricular aneurysms [8,9]. The Surgical Treatment for Ischemic Heart Failure (STICH) trial was aimed to answer the role of ventricular restoration surgery with or without coronary revascularisation [10]. STICH reported no difference in outcomes for patients undergoing ventricular remodelling surgery.…”

Section: Introductionmentioning

confidence: 99%

Impact of Surgical Ventricular Restoration on Cardiac Function, Ischaemic Mitral Regurgitation and Long-term Survival

Flemming¹

2015

J Cardiovasc Dis Diagn

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Objectives: Adverse cardiac remodelling is a major cause of morbidity and mortality post myocardial infarction. The role of surgical ventricular restoration compared to medical and electrophysiological treatments has recently come under intense scrutiny. We aimed to evaluate 10-year clinical outcomes of surgical ventricular restoration in our institution. Methods:From January 2001 to 2011, surgical ventricular restoration was performed in 126 consecutive patients (M2.3: 1F), mean age 65.5 (44-86) years. All patients presented with angina, heart failure and/or ventricular tachycardia. Post-infarction left ventricular aneurysm was present in all patients and ischemic dilated cardiomyopathy with a large akinetic left ventricle in 11.6%. The preoperative left ventricular ejection fraction was 33.1 ± 8.9%. Multi-vessel disease was present in 117/126(93%) patients. Mitral regurgitation more than grade+2 was found in 39/126(31%). The mean Logistic EuroSCORE was 13.8 ± 5.9%. A minimum of two-year post-operative follow-up was obtained on all patients.Results: Most patients underwent endoventricular or elliptical patch repair; 94% had concomitant coronary revascularisation with a median of 2 grafts and 5% had mitral valve repair. Intra-aortic balloon pump was placed preoperatively in 24/126 (19%) patients while 21/126 (17%) needed inotropic support for more than 24 h. Postoperative stroke occurred in 2 patients. In-hospital mortality was 7/126 (5.5%). All cause cardiovascular mortality at ten years was 12/126 (9.5%). Mean follow-up in operative survivors was 8.2 ± 1.2 years. Actuarial survival was 95.3%, 90.6%, 86.3% and 79.1% at 1-month, 1, 5 and 10-years. Echocardiographic follow-up demonstrated a reduction in the mean left ventricular end-diastolic volume and left atrial diameter. Ejection fraction improved over first year from 33.1 ± 8.9 to 45 ± 8.6% (P<0.006). Conclusions:Left ventricular reconstruction surgery is a good surgical option for treatment of post-infarction left ventricular aneurysm.

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Coronary Bypass Surgery with or without Surgical Ventricular Reconstruction

Cited by 657 publications

References 25 publications

Surgical Ventricular Restoration for Ischemic Cardiomyopathy with Functional Mitral Regurgitation

Surgical Ventricular Restoration for Ischemic Cardiomyopathy with Functional Mitral Regurgitation

Noninvasive assessment myocardial viability: Current status and future directions

Impact of Surgical Ventricular Restoration on Cardiac Function, Ischaemic Mitral Regurgitation and Long-term Survival

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