Outcome of left ventricular surgical remodelling after the STICH trial

Calafiore, Antonio M.; Iacò, Angela L.; Kheirallah, Hatim; Sheikh, Azmat A.; Sayed, Hussain Al; Rasheed, Mohammed El; Allam, Ahmed A.; Awadi, Mohammed O.; Alfonso, Juan J.; Osman, A.; Mauro, Michele Di

doi:10.1093/ejcts/ezw103

Cited by 17 publications

(7 citation statements)

References 25 publications

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“…Moreover, in this study fewer patients underwent CABG (71.5%) than in the RESTORE study (95%) and the STICH trial (100%). Overall, the 5-year survival in this study (72.1%) was comparable to that of the RESTORE study (68.6%), the STICH trial, and other studies ( 5 , 23 , 31 ).…”

Section: Discussionsupporting

confidence: 76%

Predictive Value of Two-Dimensional Speckle-Tracking Echocardiography in Patients Undergoing Surgical Ventricular Restoration

Nemchyna

Solowjowa

Dandel³

et al. 2022

Front. Cardiovasc. Med.

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ObjectivesParameters of left ventricular (LV) mechanics, obtained from speckle-tracking echocardiography (STE), were found to be of prognostic value in patients with heart failure and those who underwent cardiac surgery. This study aimed to assess the value of STE in patients scheduled to undergo surgical ventricular restoration (SVR).MethodsA total of 158 consecutive patients with baseline STE who underwent SVR due to an LV anteroapical aneurysm were included in the analysis. Preoperative longitudinal STE parameters were evaluated for their association with an outcome, defined as all-cause mortality, LV assist device implantation, or heart transplantation. The echocardiographic follow-up to assess the change in the regional function of the segments remote from the aneurysm was performed in 43 patients at a median of 10 months [interquartile range (IQR): 6–12.7 months] after SVR.ResultsDuring a median follow-up of 5.1 years (IQR: 1.6–8.7 years), events occurred in 68 patients (48%). Less impaired mean basal end-systolic longitudinal strain (BLS) with a cutoff value ≤ −10.1 % demonstrated a strong association with event-free survival, also in patients with an LV shape corresponding to an intermediate shape between aneurysmal and globally akinetic. Initially hypo- or akinetic basal segments with preoperative end-systolic strain ≤ −7.8% showed a greater improvement in wall motion at the short-term follow up.ConclusionPatients with less impaired preoperative BLS exhibited a better event-free survival after SVR, also those with severe LV remodeling. The preserved preoperative segmental longitudinal strain was associated with a greater improvement in regional wall motion after SVR. BLS assessment may play a predictive role in patients with an LV anteroapical aneurysm who are scheduled to undergo SVR.

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Section: Discussionsupporting

confidence: 76%

Predictive Value of Two-Dimensional Speckle-Tracking Echocardiography in Patients Undergoing Surgical Ventricular Restoration

Nemchyna

Solowjowa

Dandel³

et al. 2022

Front. Cardiovasc. Med.

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“…Although ventricle reshaping has been viewed as controversial, with a landmark surgical study showing no significant increase in survival or functional outputs (40), subsequent reports have argued this was the result of surgical reshaping that focused on volume rather than shape (39,41).…”

Section: Discussionmentioning

confidence: 99%

Structure-Function in Helical Cardiac Musculature Using Additive Textile Manufacturing

Chang

Liu

Zimmerman

et al. 2021

Preprint

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For more than fifty years, it has been hypothesized that the helical alignment of the heart gives rise to its mechanical function. Testing this hypothesis in an engineered environment is difficult, as the fine spatial features and complex three-dimensional (3D) structures of the cardiac musculature are challenging to reproduce using current biofabrication techniques. Addressing this, here we report a new form of additive textile manufacturing, Focused Rotary Jet Spinning (FRJS). FRJS allows for the rapid manufacturing of micro/nanofibers with controlled alignments. Using this method, we manufacture 3D models of the left ventricle, showing that helically aligned scaffolds display increased strain uniformity, axial shortening, cardiac output, and ejection fractions as compared to circumferential models. We then demonstrate how FRJS can enable the assembly of a full-sized model of the human heart’s musculature. This work experimentally confirms that ventricular alignment plays a critical role in ensuring healthy cardiac performance.

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“…After the outcome of the STICH Trial’s hypothesis 2, research on the treatment of SVR was intensified, and authors like Isomura [23] demonstrated that this procedure is more effective when 33% of ventricular reduction is obtained and LVESVI < 90 ml/m 2 , as well as there is no long-term benefit when SVR induces a left ventricular volume reduction < 15% and leaves residual LVESVI > 90 ml/m 2 . Calafiore [24] , in a group of patients with ischemic mitral insufficiency in 90.3% of them and NYHA III-IV in 77.9%, with mean EF of 26%, and akinetic areas at the site of ventricular scar in 86.7%, demonstrated no deaths from any cause and NYHA III-IV in 61%.…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Reconstruction Surgery in Candidates for Heart Transplantation

Contreras¹,

Orellana²,

Almeida³

et al. 2019

Braz J Cardiovasc Surg

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Objective To report our center’s experience in the surgical treatment of ventricular reconstruction, an effective and efficient technique that allows patients with end-stage heart failure of ischemic etiology to have clinical improvement and increased survival. Methods Observational, clinical-surgical, sequential, retrospective study. Patients with ischemic cardiomyopathy and left ventricular aneurysm were attended at the Heart Failure, Ventricular Dysfunction and Cardiac Transplant outpatient clinic of the Dante Pazzanese Cardiology Institute, from January 2010 to December 2016. Data from 34 patients were collected, including systemic arterial hypertension, ejection fraction, New York Heart Association (NYHA) functional classification (FC), European System for Cardiac Operative Risk Evaluation (EuroSCORE) II value, Society of Thoracic Surgeons (STS) score, ventricular reconstruction technique, and survival. Results Overall mortality of 14.7%, with hospital admission being 8.82% and late death being 5.88%. Total survival rate at five years of 85.3%. In the preoperative phase, NYHA FC was Class I in five patients, II in 18, III in eight, and IV in three vs . NYHA FC Class I in 17 patients, II in eight, III in six, and IV in three, in the postoperative period. EuroSCORE II mean value was 6.29, P ≤0.01; hazard ratio (HR) 1.16 (95% confidence interval [CI] 1.02-1.31). STS mortality/morbidity score mean value was 18.14, P ≤0.004; HR 1.19 (95% CI 1.05-1.33). Surgical techniques showed no difference in survival among Dor 81% vs . Jatene 91.7%. Conclusion Surgical treatment of left ventricular reconstruction in candidates for heart transplantation is effective, efficient, and safe, providing adequate survival.

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Outcome of left ventricular surgical remodelling after the STICH trial

Abstract: Our findings show that patients, who are candidates for LVSR, have mostly akinetic areas and CIMR requiring surgical correction and are severely symptomatic. Severe LVDD is common and, along with emergency status, is the most important risk factor for early and late outcome.

Cited by 17 publications

References 25 publications

Predictive Value of Two-Dimensional Speckle-Tracking Echocardiography in Patients Undergoing Surgical Ventricular Restoration

Predictive Value of Two-Dimensional Speckle-Tracking Echocardiography in Patients Undergoing Surgical Ventricular Restoration

Structure-Function in Helical Cardiac Musculature Using Additive Textile Manufacturing

Left Ventricular Reconstruction Surgery in Candidates for Heart Transplantation

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