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Commentary & Perspectives

Cardiovascular Medicine webinar — Coronary revascularization in patients with severe left ventricular (LV) dysfunction: Is viability testing still viable?

In this Cardiovascular Medicine webinar, Mayo Clinic cardiology experts Bernard J. Gersh, M.B., Ch.B., D.Phil., and Mandeep Singh, M.D., focus on several issues regarding coronary revascularization in patients with coronary artery disease (CAD) and severe LV dysfunction and chronic heart failure (CHF).

Mayo Clinic
In this Cardiovascular Medicine webinar, Mayo Clinic cardiology experts Bernard J. Gersh, M.B., Ch.B., D.Phil., and Mandeep Singh, M.D., focus on several issues regarding coronary revascularization in patients with coronary artery disease (CAD) and severe LV dysfunction and chronic heart failure (CHF). The concept of a paradox in which revascularization is associated with an increased early hazard but a greater long-term benefit is discussed, followed by the results of the STICH randomized trial and the myocardial viability substudy. Viability testing remains controversial and is discussed from the standpoint of pathophysiology and natural history, diagnostic modalities, the importance of quantification, and the interaction between viable myocardium, the extent of scarring and ventricular remodeling and its impact on the results of revascularization. Drs. Gersh and Singh also provide a clinical approach to the use of viability testing and coronary revascularization in specific patient subsets. For more information or to refer a patient, visit Mayo Clinic Medical Professionals — Cardiovascular Diseases.