Cardiovascular Disease Prevention Expert Forum
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Questions in the Cardiovascular Disease Prevention forum are answered by Dr. Lee Kirksey, associate professor at The University of Pennsylvania School of Medicine.

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SVR

Dr. Kirksey,
I would like your opinion about the recently completed STICH study. I have read many forums and web sites from surgeons stating the benefits of this procedure. I have an aneurism (aneurysm) in the apex . Do you think there is a place for this surgery now that the study says there are no benefits over just by-pass alone? It states that people who underwent boh CABG and SVR has 19 % less end-systolic volume compared to 6 % for people who underwent by-pass only. What does this mean exactly? Not knowing it sounds like 19 %  less compared to 6 % is a good result to me.
Thank you.
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As you know, the randomized trial compared cabg alone with cabg and surgical ventricular reconstruction. In terms of the endpoints assessed,  reduced death and cardiac hospitalization- The extra ventricular reconstruction showed no benefit. There appeared to be no benefit in terms of quality of life. Essentially, the trial noted that there is no benefit to addding the extra part of the procedure. Adding the extra portion of the procedure increases costs with no visible benefit, and increases hospital stay and intensity of care. The procedure has been done for 25 years so there will no doubt be controversy among those who would like to continue.

My opinion, wait until the dust settles and the data is analyzed completely. It appears to be the case where that data will show no benefit. Good Luck
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