The STICH trial: Misguided conclusions

Buckberg, Gerald D.; Athanasuleas, Constantine L.

doi:10.1016/j.jtcvs.2009.07.015

Cited by 93 publications

(53 citation statements)

References 25 publications

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“…We therefore decided to perform SVR with an overlapping technique and mitral valve plasty. It was previously demonstrated in a report of SVR that included more than 5,000 patients that, an approximately 40% ESVI decrease was needed for clinical improvement (28). We obtained a 44.4% reduction of ESVI in the present patient, which was considered to be one of the main factors underlying the success of our surgical procedures.…”

Section: Arg835leusupporting

confidence: 70%

Dilated Phase of Hypertrophic Cardiomyopathy Caused by Two Different Sarcomere Mutations, Treated with Surgical Left Ventricular Reconstruction and Cardiac Resynchronization Therapy with a Defibrillator

et al. 2012

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We herein report the case of a 61-year-old woman with dilated phase of hypertrophic cardiomyopathy (D-HCM) who had been diagnosed with HCM 17 years previously. On admission, her left ventricle (LV) had marked dilation, dyssynchrony with diffuse severe hypokinesis, and ventricular tachycardia. She had two mutations in the cardiac myosin binding protein-C gene, which were suspected to be the causes of the D-HCM. We performed LV reconstruction surgery and cardiac resynchronization therapy with a defibrillator for her drug-resistant severe heart failure. After surgery, her New York Heart Association class dramatically improved, and she has not been re-hospitalized since these treatments.Key words: dilated phase of hypertrophic cardiomyopathy (D-HCM), severe heart failure, sarcomere gene mutation, surgical ventricular reconstruction (SVR), cardiac resynchronization therapy with a defibrillator (CRT-D)

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Section: Arg835leusupporting

confidence: 70%

Dilated Phase of Hypertrophic Cardiomyopathy Caused by Two Different Sarcomere Mutations, Treated with Surgical Left Ventricular Reconstruction and Cardiac Resynchronization Therapy with a Defibrillator

et al. 2012

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“…4 However, despite the larger reduction in LV end-systolic volume index obtained in their study (19% versus 6%), 4 the findings are strongly debated, largely because the SVR-related volume reductions were much smaller than in other SVR trials (typically 40%). 18 In the present results, the LV end-systolic volume index decreased by 42% (52Ϯ31 mL/mm 2 ) in the SVRϩRMA group as of 2.8 months after the operation, which is in line with most previous studies at midterm follow-up, for example, the RESTORE (Reconstructive Endoventricular Surgery returning Torsion Original Radius Elliptical shape to the left ventricle) group (57Ϯ34 mL/mm 2 ), 2 Dor and coworkers (51Ϯ18 mL/mm 2 ), 16 and Di Donate and associates (average of 3 groups: 44Ϯ20 mL/mm 2 ). 17 The adverse effects of LV dilatation were codified by White and associates, 19 who showed that increased ventricular volume rather than altered ejection fraction became the principal surrogate for mortality, regardless of whether the patient had significant residual coronary artery obstruction.…”

Section: Discussionmentioning

confidence: 99%

Restrictive Mitral Annuloplasty With or Without Surgical Ventricular Restoration in Ischemic Dilated Cardiomyopathy With Severe Mitral Regurgitation

Shudo

Taniguchi²,

Takeda³

et al. 2011

Circulation

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Background-We assessed changes in left ventricular (LV) volume and function and in regional myocardial wall stress in noninfarcted segments after restrictive mitral annuloplasty (RMA) with or without surgical ventricular restoration (SVR). Methods and Results-Thirty-nine patients with ischemic cardiomyopathy (ejection fraction Յ0.35) and severe mitral regurgitation (Ն3) were studied before and 2.8 months after surgery with cine-angiographic multidetector computed tomography (cine-MDCT). Eighteen underwent RMA alone (RMA group) and 21 underwent RMA and SVR (RMAϩSVR group). In addition to measuring conventional parameters (LV end-diastolic volume index [LVEDVI], LV end-systolic volume index [LVESVI], and LV ejection fraction), we evaluated the regional circumferential end-systolic wall stress and mean circumferential fiber shortening in both the basal and mid-LV regions using 3-dimensional cine-MDCT images. LV end-diastolic and end-systolic volume indexes were significantly greater in the RMAϩSVR group than in the RMA group preoperatively, but these values did not differ significantly postoperatively. LV end-diastolic and end-systolic volume indexes decreased significantly, by 21% and 27% after RMA and by 35% and 42% after RMA and SVR, and the percent reductions in LV end-diastolic and end-systolic volume indexes were significantly larger in the RMAϩSVR group. Regional end-systolic wall stress decreased and circumferential fiber shortening increased significantly in the noninfarcted regions after RMA with or without SVR. Conclusions-RMA plus SVR showed a potentially greater reduction of LV end-diastolic and end-systolic volume indexes than RMA alone. In selected patients with more advanced LV remodeling, concomitant SVR may favorably affect the LV reverse-remodeling process induced by RMA. (Circulation. 2011;124[suppl 1]:S107-S114.)

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“…Approximately 40% of volume reduction rate was needed for clinical improvement in prior SVR reports of more than 5000 patients. 21) The adverse effects of dilatation were codified by White and associates who showed that increased ventricular volume rather than altered EF became the principal surrogate for mortality. 22) Regarding to the operative procedures, TAP was a risk factor for poor prognosis, while there was no multivariate statistical differences in mitral surgery, CABG, or different procedures of LV restoration.…”

Section: Discussionmentioning

confidence: 99%