October 6, 2004
By Ashley
Starkweather, B.S. and Asher Kimchi M.D.
Bethesda, MD – Surgery to reshape the damaged left ventricle
may provide long-term benefits to patients with advanced heart
failure. According to a new study by Athanasuleas, et al, in
the October 6, 2004 issue of the Journal of the American
College of Cardiology, surgical ventricular restoration
improved ventricular function in a group of patients with
severe heart failure.
A group of 1,198 post-infarction patients from multiple
centers in the U.S., Europe, Asia and South America underwent
surgical ventricular restoration between 1998 and 2003, and
their outcomes were examined. Prior to the surgery, 67% of
patients were NYHA functional class III or IV, while
post-surgery, 85% of patients were class I or II. Five year
freedom from hospital readmission for congestive heart failure
was 78%.
The procedure
involves identifying the margins of healthy heart tissue
surrounding the damaged area and pulling the healthy tissue
together to restore a more normal elliptical left ventricle
shape. In contrast to some earlier surgical techniques, this
procedure does not remove any heart muscle.
The results of
this study justify further investigation of surgical ventricular
restoration as a therapeutic technique for patients with
advanced heart failure. Dr. Robert H. Jones, M.D., of Duke
University Health System, who is not connected with this study,
called the results important and positive enough to justify
further study. He is part of a team that has begun a study of
heart failure patients undergoing bypass surgery that randomly
assigns some of them to also get a vertricular restoration
procedure.
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