Related Experiment Video
Updated: Feb 24, 2026
07:41
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
4.4K
Surgical ventricular remodeling: should we STICH or not?
1Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
Current Opinion in Cardiology
|August 24, 2017
Summary
Surgical revascularization improves survival and reduces hospitalizations for patients with ischemic cardiomyopathy and low ejection fraction. Recent analyses of the STICH trial confirm benefits, even in complex cases with graftable coronary artery disease.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Heart Failure Management
Background:
- Surgical management for ischemic cardiomyopathy, particularly with ejection fractions <20%, remains controversial.
- Previous trials excluded patients with ejection fractions <35%.
- Advances in medical therapy necessitate reevaluation of surgical benefits in high-risk subsets.
Purpose of the Study:
- To review data from the Surgical Treatment for Ischemic Heart Failure (STICH) trial.
- To reevaluate the role of surgical revascularization in patients with severe ischemic cardiomyopathy.
Main Methods:
- Analysis of data from the STICH trial, focusing on recent reports (2016).
- Examination of substudies evaluating surgical ventricular reconstruction and revascularization outcomes.
Main Results:
- Recent reports indicate surgery offers benefits over medical therapy for selected patients.
- Surgical ventricular reconstruction benefits appropriately selected patients with technically adequate operations.
- Surgical revascularization reduces mortality and hospitalizations in patients with graftable coronary artery disease.
Conclusions:
- Surgical revascularization provides significant reductions in overall mortality, cardiovascular deaths, and hospitalizations.
- Benefits are observed independent of symptoms, left ventricular size/function, viability, or inducible ischemia.
- Appropriately selected surgical candidates with graftable coronary artery disease benefit from revascularization.
