MedStar Authors catalog › Details for: Myocardial viability and impact of surgical ventricular reconstruction on outcomes of patients with severe left ventricular dysfunction undergoing coronary artery bypass surgery: results of the Surgical Treatment for Ischemic Heart Failure trial.
Myocardial viability and impact of surgical ventricular reconstruction on outcomes of patients with severe left ventricular dysfunction undergoing coronary artery bypass surgery: results of the Surgical Treatment for Ischemic Heart Failure trial. ISSN: 0022-5223. UI/PMID: 25152476. Subject(s): Aged | Cardiomyopathies/di [Diagnosis] | Cardiomyopathies/mo [Mortality] | Cardiomyopathies/pp [Physiopathology] | *Cardiomyopathies/su [Surgery] | Coronary Artery Bypass/ae [Adverse Effects] | Coronary Artery Bypass/mo [Mortality] | *Coronary Artery Bypass | Coronary Artery Disease/di [Diagnosis] | Coronary Artery Disease/mo [Mortality] | Coronary Artery Disease/pp [Physiopathology] | *Coronary Artery Disease/su [Surgery] | Female | Heart Failure/di [Diagnosis] | Heart Failure/pp [Physiopathology] | *Heart Failure/su [Surgery] | Humans | Kaplan-Meier Estimate | Male | Middle Aged | *Myocardium/pa [Pathology] | Predictive Value of Tests | Proportional Hazards Models | Reconstructive Surgical Procedures/ae [Adverse Effects] | Reconstructive Surgical Procedures/mo [Mortality] | *Reconstructive Surgical Procedures | Severity of Illness Index | Time Factors | Tissue Survival | Tomography, Emission-Computed, Single-Photon | Treatment Outcome | Ventricular Dysfunction, Left/di [Diagnosis] | Ventricular Dysfunction, Left/mo [Mortality] | Ventricular Dysfunction, Left/pp [Physiopathology] | *Ventricular Dysfunction, Left/su [Surgery] | *Ventricular Function, Left Institution(s): MedStar Heart & Vascular Institute Activity type: Journal Article. Digital Object Identifier: http://dx.doi.org/10.1016/j.jtcvs.2014.06.090 (Click here) Abbreviated citation: J Thorac Cardiovasc Surg. 148(6):2677-84.e1, 2014 Dec. Local Holdings: Available online from MWHC library: 1994 - present, Available in print through MWHC library: 1999 - 2006. Abstract: OBJECTIVES: In the Surgical Treatment for Ischemic Heart Failure trial, surgical ventricular reconstruction plus coronary artery bypass surgery was not associated with a reduction in the rate of death or cardiac hospitalization compared with bypass alone. We hypothesized that the absence of viable myocardium identifies patients with coronary artery disease and left ventricular dysfunction who have a greater benefit with coronary artery bypass graft surgery and surgical ventricular reconstruction compared with bypass alone. Abstract: METHODS: Myocardial viability was assessed by single photon computed tomography in 267 of the 1000 patients randomized to bypass or bypass plus surgical ventricular reconstruction in the Surgical Treatment for Ischemic Heart Failure. Myocardial viability was assessed on a per patient basis and regionally according to prespecified criteria. Abstract: RESULTS: At 3 years, there was no difference in mortality or the combined outcome of death or cardiac hospitalization between those with and without viability, and there was no significant interaction between the type of surgery and the global viability status with respect to mortality or death plus cardiac hospitalization. Furthermore, there was no difference in mortality or death plus cardiac hospitalization between those with and without anterior wall or apical scar, and no significant interaction between the presence of scar in these regions and the type of surgery with respect to mortality.
Abstract: CONCLUSIONS: In patients with coronary artery disease and severe regional left ventricular dysfunction, assessment of myocardial viability does not identify patients who will derive a mortality benefit from adding surgical ventricular reconstruction to coronary artery bypass graft surgery.Copyright � 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.