Ventricular Reconstruction During CABG Offers No Clinical Benefit

Surgical reduction of left ventricular volume during CABG offers no clinical advantage over bypass alone, according to a study presented at the American College of Cardiology conference and published online in the New England Journal of Medicine.

International STICH investigators randomized 1000 patients with coronary artery disease and left ventricular ejection fractions of 35% or less to one of two treatments. Half received CABG alone, and the other half received CABG plus ventricular reconstruction — a procedure in which the left ventricle is reduced in volume by surgical exclusion of damaged myocardium.

After a median 4-year follow-up, the primary outcome — a composite of death from any cause or hospitalization for cardiac causes — did not differ between the groups.

Writing in Journal Watch Cardiology, Harlan Krumholz says that although many believed the surgical approach would work, the results are "yet another illustration of why we need to carefully evaluate new interventions."