Related Experiment Videos
[Surgery in heart failure (without transplantation)]
O Baron1, O al Habash, J N Trochu
1Pôle thoracique et cardiovasculaire, hôpital G. et R. Laennec, 44093 Nantes.
Insights
For end-stage heart failure, surgical alternatives to heart transplantation are explored due to graft scarcity. Coronary revascularization shows promising results for viable myocardial zones.
Area of Science:
- Cardiology
- Cardiac Surgery
- Transplantation
Context:
- End-stage heart failure necessitates advanced treatments like cardiac transplantation.
- A significant shortage of donor hearts limits transplantation options.
- Patients seek surgical interventions to improve condition and postpone transplant.
Purpose:
- To explore surgical alternatives for patients with end-stage heart failure awaiting transplantation.
- To surgically address underlying cardiac lesions contributing to heart failure.
Summary:
- Surgical options include valvular surgery, coronary artery bypass grafting, ventricular remodeling, and cardiomyoplasty.
- Coronary revascularization yields the most significant improvements.
- Treatment success depends on targeting viable myocardial tissue identified via stress echocardiography or PET scans.
Impact:
- Offers viable therapeutic strategies for patients ineligible for immediate heart transplant.
- Improves clinical outcomes and quality of life for advanced heart failure patients.
- Highlights the importance of myocardial viability assessment in surgical planning.
Abstract:
Cardiac transplant remains the treatment of reference for end-stage cardiac insufficiency. The very great disparity between the number of grafts available and the number of patients eligible to be included on the transplant list drives some of them to contemplate a surgical alternative in order to improve their clinical condition and to delay as much as possible the date of transplant. The objective is to treat surgically one or several of the lesions causing the cardiac insufficiency. It could be valvular surgery, coronary surgery or a combination of both, ventricular remodelling or cardiomyoplasty. It is coronary revascularisation surgery which gives the most spectacular results on condition that it is aimed at the myocardial zones for which viability has been demonstrated by stress echocardiography or a PET scan.