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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.

Publication ,  Journal Article
Holly, TA; Bonow, RO; Arnold, JMO; Oh, JK; Varadarajan, P; Pohost, GM; Haddad, H; Jones, RH; Velazquez, EJ; Birkenfeld, B; Asch, FM; Sun, J-L ...
Published in: The Journal of thoracic and cardiovascular surgery
December 2014

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.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.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.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.

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Published In

The Journal of thoracic and cardiovascular surgery

DOI

EISSN

1097-685X

ISSN

0022-5223

Publication Date

December 2014

Volume

148

Issue

6

Start / End Page

2677 / 84.e1

Related Subject Headings

  • Ventricular Function, Left
  • Ventricular Dysfunction, Left
  • Treatment Outcome
  • Tomography, Emission-Computed, Single-Photon
  • Tissue Survival
  • Time Factors
  • Severity of Illness Index
  • Respiratory System
  • Proportional Hazards Models
  • Predictive Value of Tests
 

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Holly, T. A., Bonow, R. O., Arnold, J. M. O., Oh, J. K., Varadarajan, P., Pohost, G. M., … Panza, J. A. (2014). 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. The Journal of Thoracic and Cardiovascular Surgery, 148(6), 2677-84.e1. https://doi.org/10.1016/j.jtcvs.2014.06.090
Holly, Thomas A., Robert O. Bonow, J Malcolm O. Arnold, Jae K. Oh, Padmini Varadarajan, Gerald M. Pohost, Haissam Haddad, et al. “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.The Journal of Thoracic and Cardiovascular Surgery 148, no. 6 (December 2014): 2677-84.e1. https://doi.org/10.1016/j.jtcvs.2014.06.090.
Holly, Thomas A., et al. “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.The Journal of Thoracic and Cardiovascular Surgery, vol. 148, no. 6, Dec. 2014, pp. 2677-84.e1. Epmc, doi:10.1016/j.jtcvs.2014.06.090.
Holly TA, Bonow RO, Arnold JMO, Oh JK, Varadarajan P, Pohost GM, Haddad H, Jones RH, Velazquez EJ, Birkenfeld B, Asch FM, Malinowski M, Barretto R, Kalil RAK, Berman DS, Sun J-L, Lee KL, Panza JA. 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. The Journal of thoracic and cardiovascular surgery. 2014 Dec;148(6):2677–84.e1.
Journal cover image

Published In

The Journal of thoracic and cardiovascular surgery

DOI

EISSN

1097-685X

ISSN

0022-5223

Publication Date

December 2014

Volume

148

Issue

6

Start / End Page

2677 / 84.e1

Related Subject Headings

  • Ventricular Function, Left
  • Ventricular Dysfunction, Left
  • Treatment Outcome
  • Tomography, Emission-Computed, Single-Photon
  • Tissue Survival
  • Time Factors
  • Severity of Illness Index
  • Respiratory System
  • Proportional Hazards Models
  • Predictive Value of Tests