Featured Research

from universities, journals, and other organizations

Surgery To Reshape Ventricle In Heart Failure Patients Offers No Added Benefit Over Bypass, Study Shows

Date:
March 30, 2009
Source:
Duke University Medical Center
Summary:
A surgical procedure to resize an enlarged, weakened heart muscle during coronary bypass surgery for heart failure adds cost and risk but doesn't offer patients any additional benefit when compared with those who received bypass procedure alone, according to new research.

A surgical procedure to resize an enlarged, weakened heart muscle during coronary bypass surgery for heart failure adds cost and risk but doesn't offer patients any additional benefit when compared with those who received bypass procedure alone, according to researchers from the Duke Clinical Research Institute (DCRI).

Related Articles


Duke researchers examined quality of life and cost issues among 1000 patients with heart failure enrolled in the STICH trial (Surgical Treatment for Ischemic Heart Failure), a multi-center, international clinical trial that compared clinical outcomes between patients who had bypass surgery alone with those who had bypass combined with a second procedure, called surgical ventricular reconstruction (SVR).

Surgical ventricular reconstruction has been added to coronary bypass surgery for nearly 25 years in selected patients with heart failure. The procedure involves removing dead or damaged sections of the front wall of the heart and reshaping the left ventricle to create a more normally-sized, stronger heart that can beat more efficiently.

The primary results from the STICH trial, also being reported at the American College of Cardiology's 58th Annual Scientific Session,* showed that SVR offered no additional benefit in terms of reduced death or cardiac hospitalization, the primary endpoints of the study.

In a separate part of the study, researchers also compared quality of life and cost outcomes in the two treatment arms of the STICH trial.

Led by Daniel Mark, M.D., Director of Outcomes Research at the DCRI, researchers used the Kansas City Cardiomyopathy Questionnaire and other specialized instruments to evaluate various aspects of patients' lives for up to three years after their surgery. Researchers also collected resource use and cost data on 196 patients who were enrolled in the trial in the United States.

After reviewing all the data, researchers found that members of both treatment groups improved substantially post-operatively, but they did not find any significant differences between the two groups' quality of life measures. They also discovered that hospitalization costs averaged over $14,500 higher for patients who received SVR in addition to bypass, mostly due to 4.2 extra days of high-intensity post-operative care in the hospital.

"The take home message is that coronary bypass surgery in this population substantially improves functioning and quality of life, but adding SVR does not provide any further improvement over that provided by bypass alone," says Mark. "However, adding SVR substantially increased the cost of the operation, so we can't see any justification for routine use of this option in patients with heart failure who need bypass surgery."

"The STICH trial illustrates how comparative effectiveness studies benefit physicians, patients and the overall health care system," says Kevin Anstrom, Ph.D., lead statistician of the quality of life study. "This trial compared two therapies for the same malady and found that the riskier, more expensive treatment did not improve patients' survival or quality of life. These findings can help save health care resources while maintaining quality of care."

The National Heart, Lung, and Blood Institute funded the study, which will also appear online Monday in the American Heart Journal.

Additional investigators from Duke who contributed to the study include David Knight, Tina Harding and Laura Drew, from the Outcomes Research Group; and Eric Velazquez and Gena Rankin, from DCRI. Additional co-authors include Jonathan Howlett, from the University of Calgary; John Spertus, from the Mid America Heart Institute; Ljubomir Djokovic, of the Dedinje Cardiovascular Institute, Belgrade; Bozena Szygula-Jurkiewicz, from the Silesian Center for Heart Disease, Poland; and Christopher Adlbrecht from the Medical University of Vienna.

*Dr. Mark will present details of the STICH QOL study on March 31, as part of an ACC Late-Breaking Clinical Trials presentation at the Orange County Convention Center.


Story Source:

The above story is based on materials provided by Duke University Medical Center. Note: Materials may be edited for content and length.


Cite This Page:

Duke University Medical Center. "Surgery To Reshape Ventricle In Heart Failure Patients Offers No Added Benefit Over Bypass, Study Shows." ScienceDaily. ScienceDaily, 30 March 2009. <www.sciencedaily.com/releases/2009/03/090330091704.htm>.
Duke University Medical Center. (2009, March 30). Surgery To Reshape Ventricle In Heart Failure Patients Offers No Added Benefit Over Bypass, Study Shows. ScienceDaily. Retrieved October 31, 2014 from www.sciencedaily.com/releases/2009/03/090330091704.htm
Duke University Medical Center. "Surgery To Reshape Ventricle In Heart Failure Patients Offers No Added Benefit Over Bypass, Study Shows." ScienceDaily. www.sciencedaily.com/releases/2009/03/090330091704.htm (accessed October 31, 2014).

Share This



More Health & Medicine News

Friday, October 31, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Melafind: Spotting Melanoma Without a Biopsy

Melafind: Spotting Melanoma Without a Biopsy

Ivanhoe (Oct. 31, 2014) The MelaFind device is a pain-free way to check suspicious moles for melanoma, without the need for a biopsy. Video provided by Ivanhoe
Powered by NewsLook.com
Battling Multiple Myeloma

Battling Multiple Myeloma

Ivanhoe (Oct. 31, 2014) The answer isn’t always found in new drugs – repurposing an ‘old’ drug that could mean better multiple myeloma treatment, and hope. Video provided by Ivanhoe
Powered by NewsLook.com
Chronic Inflammation and Prostate Cancer

Chronic Inflammation and Prostate Cancer

Ivanhoe (Oct. 31, 2014) New information that is linking chronic inflammation in the prostate and prostate cancer, which may help doctors and patients prevent cancer in the future. Video provided by Ivanhoe
Powered by NewsLook.com
Sickle Cell: Stopping Kids’ Silent Strokes

Sickle Cell: Stopping Kids’ Silent Strokes

Ivanhoe (Oct. 31, 2014) Blood transfusions are proving crucial to young sickle cell patients by helping prevent strokes, even when there is no outward sign of brain injury. Video provided by Ivanhoe
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins