Revascularization and ventricular restoration in patients with ischemic heart failure: the STICH trial.
OBJECTIVE
As techniques for the management of patients with ischemic heart failure have evolved, controversy has arisen with respect to the roles of revascularization and ventricular restoration procedures. This review addresses current thinking on the management of these patients and describes a prospective randomized trial that will have an impact on future treatment selection.


RESULTS
Although the basis for improved survival with coronary artery bypass grafting lies in the viability of ischemic myocardium, nuclear medicine studies and stress echocardiography have failed to adequately select for tissues that are capable of recovery. Recent studies have suggested an additional benefit to combining ventricular restoration with bypass surgery. However, the role for these techniques has not been definitively established.


CONCLUSIONS
The currently enrolling Surgical Treatment for Ischemic Heart Failure (STICH) trial promises to address these issues and thereby improve the management of patients with this disease.
Division of Transplantation and Assist Devices, M.E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
David
D
Joyce
Matthias
M
Loebe
George P
GP
Noon
Susan
S
McRee
Robert
R
Southard
Larry
L
Thompson
Christian
C
Skrabal
Keith
K
Youker
Guillermo
G
Torre-Amione
D001026:Coronary Artery Bypass; D006333:Heart Failure / Q000503:physiopathology* / Q000601:surgery*; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D017202:Myocardial Ischemia / Q000503:physiopathology* / Q000601:surgery*; D014481:United States / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000601:surgery; D016276:Ventricular Function / Q000502:physiology*