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Eur J Cardiothorac Surg 2006;30:759-761
© 2006 Elsevier Science NL

Editorial comment

Left ventricular reconstruction for dilated ischemic cardiomyopathy: biology, registry, randomization, and credibility

Division of Cardiothoracic Surgery, Los Angeles UCLA School of Medicine, Los Angeles, CA 90095-1741, USA

^_* Tel.: +1 310 2061027; fax: +1 310 8255895. (Email: gbuckberg@mednet.ucla.edu).

The first 20% of the full text of this article appears below.

Left ventricular reconstruction or restoration shall become the emerging field of treating dilated cardiomyopathy from either ischemic causes, as in this report from the Cleveland Clinic, or subsequently from valvular and nonischemic cardiomyopathy [1], because surgical rebuilding geometrically changes the diseased spherical chamber into a more natural elliptical form. Registry data confirms collaborative information from the RESTORE multicenter cohort [2], and Dor [3] who launched this surgical evolution. Furthermore, these functional and mortality late findings are unachievable by CABG with or without mitral valve procedures [4–6].

Randomized testing is underway in the STICH trial, and the Cleveland Clinic re-establishes its vital importance by mirroring their 1978 report regarding the VA Hospital CABG trial [7]. The prior question investigated if a closed artery should be opened, whereas this article tests a comparable biologic principle by surveying mechanical changing of a diseased sphere into conical form with restoration. The original answer was to open the vessel, but revascularization results became distorted by inexperience at the VA centers (2–13% mortality with higher death rate in centers with uncommon cases) [8] compared with 1% CCF mortality in >1000 patients. Now, the . . . [Full Text of this Article]