Speaker: Bernard J. Gersh, M.B., Ch.B., D.Phil. and Moderator: Mandeep Singh, M.D.
This webinar will focus on several issues regarding coronary revascularization in patients with CAD and severe LV dysfunction and CHF. The concept of a paradox in which revascularization is associated with an increased early hazard but a greater long-term benefit will be discussed followed by the results of the STICH randomized trial and the viability substudy. Viability testing remains controversial and will be discussed from the standpoint of the pathophysiology and natural history, diagnostic modalities, the importance of quantification and the interaction between viable myocardium, the extent of scar and ventricular remodeling and its impact upon the results of revascularization. In conclusion I will provide a clinical approach to the use of viability testing and coronary revascularization in specific patient subsets.
1) Discuss the results of the STICH trial and the viability substudy emphasizing the concept of increased periprocedural risk but a potentially greater long benefit.
2) Clarify the prognostic role of myocardial viability from the standpoint of pathophysiology, quantification and the interaction between viability, extent of scar and extent of ventricular remodeling.
3) Discuss a clinical approach to use of viability testing and revascularization in specific patient subsets.