Favorable effects of left ventricular reconstruction in patients excluded from the Surgical Treatments for Ischemic Heart Failure (STICH) trial

Abstract

With minimal associated mortality, left ventricular reconstruction produces durable improvement in left ventricular function in patients with a large scarred ventricular wall. Considering that this patient cohort would have been systematically excluded from the STICH trial, care should be taken not to extrapolate that study's results too widely so as to inappropriately deny selected patients an effective treatment for ischemic cardiomyopathies with an injured ventricle.

2018 ESC/EACTS Guidelines on myocardial revascularization

“…253 In the STICH trial, a post-operative LV end-systolic volume index < _70 mL/m 2 , after CABG plus SVR, resulted in improved survival compared with CABG alone. 252,254 In experienced centres, SVR may be done at the time of CABG if HF Routine revascularization of non-IRA lesions should be considered in patients with multivessel disease before hospital discharge.…”

“…[252][253][254]256,257 IIb B CABG = coronary artery bypass grafting; LV = left ventricular; NYHA = New York Heart Association; PCI = percutaneous coronary intervention. …”

The Relationship between Time from Myocardial Infarction, Left Ventricular Dyssynchrony, and the Risk for Ventricular Arrhythmia: Speckle-Tracking Echocardiographic Analysis

“…15,16 In the present analysis, the following events occurring before the occurrence of the primary end point of monomorphic VT were treated as competing risks: ventricular fibrillation, polymorphic VT, ICD upgrade, coronary revascularization, and LV reconstructive surgery. [17][18][19] The covariates that were examined as potential predictors of monomorphic VT were chosen on the basis of clinical relevance or demonstrated prognostic value after MI. These covariates included.…”

Recognition, assessment and management of the mechanical complications of acute myocardial infarction

“…Assessment of myocardial viability and the use of advanced imaging techniques, especially cardiac MRI and multislice CTA are highly advisable during preoperative planning (figure 6A–D). 37 …”