Key result
Surgical ventricular restoration is an option for post-infarction ischemic cardiomyopathy, and the ongoing STICH trial will assess its benefit over coronary bypass alone.
Why the study?
Does surgical ventricular restoration added to coronary bypass improve outcomes in patients with post-infarction ischemic cardiomyopathy?
Does surgical ventricular restoration added to coronary bypass improve outcomes in patients with post-infarction ischemic cardiomyopathy?
This review highlights the pathophysiologic rationale and expectations for the STICH trial to determine the efficacy of surgical ventricular restoration in ischemic cardiomyopathy.
May be considered in selected post-infarction cases; leaves open incremental benefit over bypass alone pending STICH.
Post-infarction ischemic cardiomyopathy is the most frequent cause of clinical heart failure in the western society. Despite aggressive early revascularization, myocardial infarction leaves shape and function abnormalities in a consistent number of patients with increased risk of death and ischemic events. Alternative treatment strategies are therefore advisable in these high-risk patients. Surgical ventricular restoration (SVR) is a safe and effective surgical option for post-infarction ischemic cardiomyopathy resulting in improvement of pump function, functional class and survival. Observational data now need to be confirmed by randomized data and the multicenter international randomized surgical treatment of ischemic heart failure (STICH) trial will definitely assess if SVR adds benefit to coronary bypass alone in patients with left ventricular dysfunction and dilated ventricle.
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Menicanti et al. (2004) conducted a review in Post-infarction ischemic cardiomyopathy. Surgical ventricular restoration (SVR) vs. Coronary bypass alone was evaluated. Surgical ventricular restoration is an option for post-infarction ischemic cardiomyopathy, and the ongoing STICH trial will assess its benefit over coronary bypass alone.
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