TITLE:
Review: Do We Still Need a Viability Study before Considering Revascularization in Patient with Stable Coronary Artery Disease and Significant Left Ventricular Systolic Dysfunction?
AUTHORS:
Hanan Albackr, Abdulelah F. Al Mobeirek, Mostafa Al Shamiri, Turki B. Albacker
KEYWORDS:
Viability; Revascularization; Coronary Artery Bypass Grafting; Left Ventricular Dysfunction
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.5 No.5,
March
21,
2014
ABSTRACT: Patients with ischemic cardiomyopathy constitute a
heterogeneous group of patients with an extremely complex condition in which
many factors play an important prognostic role. So it is difficult and probably
unrealistic to expect that a single feature like presence of viable myocardium
would provide an unequivocal answer to a critical question of revasculrization
or not for all patients. Opposite to the hopes of investigators and physicians
involved in the care of these patients, the findings of prospective studies
with the use of different viability testing methods did not help in the
decision-making process regarding CABG in ischemic cardiomyopathy. Instead,
they left us with the same dilemma. The implication of most of these trials is that in patients with CAD and significant LV dysfunction, assessment of
myocardial viability does not identify patients who will have the greatest
survival benefit from adding CABG to aggressive medical therapy. In the
clinical practice, these observations remind physicians to consider the
multiplicity of factors involved in the decision-making process for patients
with such a complex disease.