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Heart, Lung and Circulation

Lack of Viability Should Not Deny Surgical Revascularisation to Patients With Poor Left Ventricular Function

      Recently in Heart, Lung and Circulation, Sharma et al. [
      • Sharma V.J.
      • Arghami A.
      • Pasupula D.K.
      • Haddad A.
      • Ke J.X.C.
      Outcomes of coronary artery bypass grafting in patients with poor myocardial vioability: A systematic review and meta-analysis of the last decade.
      ] reported an elegant meta-analysis of coronary artery bypass grafting (CABG) outcomes in patients with poor myocardial viability. The study included seven articles with 993 patients with a median age of 54.8–67.2 years, and follow-up of between 12–125 months. The absence of an interaction between myocardial viability and gain from CABG in this study indicates that estimation of myocardial viability alone should not be the deciding factor in selecting the best therapy for these patients. However, the studies were not powered to assess outcomes post CABG and had the limitation of significant heterogeneity in viability assessment—we congratulate the authors on their attempts to adjust for heterogeneity through use of a random-effects model.

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