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Restoring ventricular restoration: A call to re-evaluate a surgical therapy considered ineffective

Torsten Doenst1, Eric J Velazquez2, Robert E Michler3

  • 1Department of Cardiothoracic Surgery, Friedrich-Schiller-University of Jena, University Hospital Jena, Jena, Germany.

Journal of Cardiac Surgery
|January 13, 2021
PubMed

Insights

Surgical restoration of postischemically dilated left ventricles (SVR) is under scrutiny after the STICH trial. A new analysis aims to re-evaluate SVR

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Outcomes
  • Ischemic Heart Disease Management

Background:

  • The Surgical Treatment of IsChemic Heart failure (STICH) Trial reported no benefit for surgical restoration of postischemically dilated left ventricles (SVR) in patients with coronary artery disease (CAD) and low ejection fraction.
  • Criticism suggests the STICH trial's patient selection and surgical expertise may have limited its ability to assess SVR's true potential, particularly in aneurysm patients.

Purpose of the Study:

  • To address the controversy surrounding the STICH trial's findings on SVR.
  • To propose and justify a new analysis comparing STICH patients with a cohort of SVR patients treated by an expert center.

Main Methods:

  • The proposed study will compare the patient population from the STICH trial with a comparable group of SVR patients.
  • The comparison group will consist of patients treated at a center with documented expertise in SVR.

Main Results:

  • The abstract does not contain specific results, but discusses the rationale for a future analysis.

Conclusions:

  • The proposed comparative analysis has the potential to provide valuable insights into the efficacy of SVR.
  • Re-evaluating SVR with improved patient selection and surgical expertise may clarify its role in treating ischemic heart failure.

Keywords:
aneurysmcardiac surgeryheart failuresurgical ventricular reconstruction

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