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New Surgery for Heart Failure Proves Ineffective
Date:3/29/2009

Isolating damaged heart tissue does not produce better outcomes, study finds,,,,,,

SUNDAY, March 29 (HealthDay News) -- A surgical procedure called ventricular reconstruction that doctors hoped would improve symptoms in people with heart failure does not seem to work, a new study has found.

The hope was that by isolating the damaged part of the left ventricle -- the chamber of the heart that pumps blood to the body -- people would see an improvement in symptoms and exercise capacity, and there would be fewer deaths and hospitalizations as well.

"There has been interest among certain proponents in using a surgical approach to treat ventricular remodeling that can occur after heart attacks through left ventricular volume reduction surgery," said Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, who was not involved in the study. "However, evidence of safety and efficacy for this surgical approach was lacking."

But the new study findings "demonstrate that the addition of surgical ventricular reconstruction to standard coronary artery bypass surgery does not result in any clinically meaningful improvement in outcomes," he said. "The use of this type of surgery, which has become common in certain [medical] centers should, with few exceptions, now cease."

The findings were reported online March 29 in the New England Journal of Medicine, to coincide with a presentation of the study at the American College of Cardiology annual meeting in Orlando, Fla.

For the study, Dr. Robert H. Jones, of the Duke Clinical Research Institute, and his colleagues randomly assigned 1,000 people with heart failure, all participants in the Surgical Treatment for Ischemic Heart Failure (STICH) trial, to cardiac bypass surgery alone or bypass surgery plus ventricular reconstruction.

Ventricular reconstruction involves making an incision in the damaged part of
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