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

Thomas A. Holly, Robert O. Bonow, J. Malcolm O Arnold, Jae Kuen Oh, Padmini Varadarajan, Gerald M. Pohost, Haissam Haddad, Robert H. Jones, Eric J. Velazquez, Bozena Birkenfeld, Federico M. Asch, Marcin Malinowski, Rodrigo Barretto, Renato A K Kalil, Daniel S. Berman, Jie Lena Sun, Kerry L. Lee, Julio A. Panza

Research output: Contribution to journalArticle

13 Citations (Scopus)

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.

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.

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.

Original languageEnglish (US)
Pages (from-to)2677-2684
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume148
Issue number6
DOIs
StatePublished - Dec 1 2014

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Left Ventricular Dysfunction
Coronary Artery Bypass
Heart Failure
Mortality
Hospitalization
Cicatrix
Coronary Artery Disease
Therapeutics
Transplants
Myocardium

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

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. / Holly, Thomas A.; Bonow, Robert O.; Arnold, J. Malcolm O; Oh, Jae Kuen; Varadarajan, Padmini; Pohost, Gerald M.; Haddad, Haissam; Jones, Robert H.; Velazquez, Eric J.; Birkenfeld, Bozena; Asch, Federico M.; Malinowski, Marcin; Barretto, Rodrigo; Kalil, Renato A K; Berman, Daniel S.; Sun, Jie Lena; Lee, Kerry L.; Panza, Julio A.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 148, No. 6, 01.12.2014, p. 2677-2684.

Research output: Contribution to journalArticle

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, JL, Lee, KL & Panza, JA 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', Journal of Thoracic and Cardiovascular Surgery, vol. 148, no. 6, pp. 2677-2684. https://doi.org/10.1016/j.jtcvs.2014.06.090
Holly, Thomas A. ; Bonow, Robert O. ; Arnold, J. Malcolm O ; Oh, Jae Kuen ; Varadarajan, Padmini ; Pohost, Gerald M. ; Haddad, Haissam ; Jones, Robert H. ; Velazquez, Eric J. ; Birkenfeld, Bozena ; Asch, Federico M. ; Malinowski, Marcin ; Barretto, Rodrigo ; Kalil, Renato A K ; Berman, Daniel S. ; Sun, Jie Lena ; Lee, Kerry L. ; Panza, Julio A. / 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. In: Journal of Thoracic and Cardiovascular Surgery. 2014 ; Vol. 148, No. 6. pp. 2677-2684.
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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.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.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.",
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T2 - Results of the Surgical Treatment for Ischemic Heart Failure trial

AU - Holly, Thomas A.

AU - Bonow, Robert O.

AU - Arnold, J. Malcolm O

AU - Oh, Jae Kuen

AU - Varadarajan, Padmini

AU - Pohost, Gerald M.

AU - Haddad, Haissam

AU - Jones, Robert H.

AU - Velazquez, Eric J.

AU - Birkenfeld, Bozena

AU - Asch, Federico M.

AU - Malinowski, Marcin

AU - Barretto, Rodrigo

AU - Kalil, Renato A K

AU - Berman, Daniel S.

AU - Sun, Jie Lena

AU - Lee, Kerry L.

AU - Panza, Julio A.

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N2 - 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.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.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.

AB - 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.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.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.

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