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Is Ventricular Reconstruction Effective for Heart Failure Patients?

Posted May 20 2009 9:30am
Heart failure is a condition in which the heart is unable to supply sufficient blood flow to meet the body’s needs, and it often occurs after tissue is damaged by a heart attack. Generally, a person can develop heart failure because of myocardial infarction and other forms of ischemic heart disease, hypertension (high blood pressure), valvular heart disease and cardiomyopathy. About 5 million people in the United States are affected by heart failure.

When the heart fails, it will try to compensate for the damage by getting larger, but in the meantime, it will also pump much less efficiently. Ventricular reconstruction is an operation that is designed to help patients with heart failure. It involves folding the scarred portion of a damaged heart in on itself to get it to beat more effectively.

However, in a so-called STICH trial, doctors from Duke University Medical Center in North Carolina found that such operation provides no real benefit to most patients. Basing on work carried out at 96 medical centers in 23 countries, the findings were presented on March 29, 2009 at a meeting of the American College of Cardiology in Orlando and published in the New England Journal of Medicine.

During the STICH trial, doctors compared what happened to the 1,000 volunteers, who all got heart bypass operations, and half of them also got ventricular reconstruction. The results showed that ventricular reconstruction neither lowered the death rate or the risk of going back to the hospital nor improved the quality of life after 4 years.

No doubt, many patients have a lot fewer symptoms with the operation, but some patients could have the similar improvement with good medical treatment involving drugs. In fact, a patient will save an average of US$14,595 in the hospital costs, and the patient will spend one half hour less in the operating room.

Nevertheless, the operation is seldom carried out in the United States. In fact, only 3,000 to 5,000 such operations have been done worldwide in the last 10 years.
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