Ventricular reconstruction to improve symptoms in people with heart failure, a procedure often done in conjunction with heart bypass, not only failed to reduce deaths and hospitalizations in heart failure patients but also did not improve patients’ quality of life compared to bypass alone after four years of follow-up, according to findings from a large international clinical trial sponsored by the National Heart, Lung, and Blood Institutes of Health.

 

The trial, called Surgical Treatment for Ischemic Heart Failure (STICH), was presented at the American College of Cardiology scientific meeting in Orlando, Florida and can be found in this week’s online issue of the New England Journal of Medicine.

 

For the study, researchers at the Duke Clinical Research Institute randomly assigned 1,000 people suffering from heart failure to cardiac bypass surgery alone or bypass surgery plus ventricular reconstruction.

 

The patients were then followed for a period of 48 months. At the end of this period, the researchers found that people who underwent both procedures had 19 percent less “end-systolic volume,” compared with 6 percent less volume for those who had just bypass surgery. But ventricular reconstruction failed to improve symptoms in heart failure patients, did not improve their ability to exercise or reduced their risk of death or hospitalization.

 

“The results of the STICH trial demonstrate that routine use of surgery to reconstruct the left ventricle does not improve survival, hospitalization, quality of life or cost benefit over bypass surgery alone,” said George Sopko, M.D., a medical officer at NHLBI and co-author of the mortality paper in NEJM. He also added that he is looking for additional analysis of the results as patients continue to e followed.