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Restoration Surgery May Have Long-term Benefits for Heart Failure Patients  

October 6, 2004

By Ashley Starkweather, B.S. and Asher Kimchi M.D.

Bethesda, MD Surgery to reshape the damaged left ventricle may provide long-term benefits to patients with advanced heart failure. According to a new study by Athanasuleas, et al, in the October 6, 2004 issue of the Journal of the American College of Cardiology, surgical ventricular restoration improved ventricular function in a group of patients with severe heart failure.  

A group of 1,198 post-infarction patients from multiple centers in the U.S., Europe, Asia and South America underwent surgical ventricular restoration between 1998 and 2003, and their outcomes were examined. Prior to the surgery, 67% of patients were NYHA functional class III or IV, while post-surgery, 85% of patients were class I or II. Five year freedom from hospital readmission for congestive heart failure was 78%. 

The procedure involves identifying the margins of healthy heart tissue surrounding the damaged area and pulling the healthy tissue together to restore a more normal elliptical left ventricle shape. In contrast to some earlier surgical techniques, this procedure does not remove any heart muscle. 

The results of this study justify further investigation of surgical ventricular restoration as a therapeutic technique for patients with advanced heart failure. Dr. Robert H. Jones, M.D., of Duke University Health System, who is not connected with this study, called the results important and positive enough to justify further study. He is part of a team that has begun a study of heart failure patients undergoing bypass surgery that randomly assigns some of them to also get a vertricular restoration procedure. 

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