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Contemporary Medical, Surgical, and Device Therapies for End-stage Heart Failure

Rajan Krishnamani1, Mohamad El-Zaru, David DeNofrio

  • 1Cardiac Transplantation Program, Division of Cardiology, Tufts-New England Medical Center, 750 Washington Street, Boston, MA 02111, USA. ddenofrio@tufts-nemc.org

Current Treatment Options in Cardiovascular Medicine
|October 25, 2003
PubMed

Insights

Despite medical advances, heart failure (HF) mortality remains high. Alternative surgical and device therapies show promise for managing advanced HF, improving symptoms and survival.

Area of Science:

  • Cardiology
  • Medical Therapy
  • Surgical Interventions

Background:

  • High mortality rates persist in heart failure (HF) patients despite medical advancements.
  • Cardiac transplantation is limited by donor availability for end-stage HF.
  • Aging populations and complex comorbidities increase HF incidence and prevalence.

Purpose of the Study:

  • To review alternative surgical and device-based treatment strategies for advanced heart failure.
  • To assess the effectiveness of these novel therapies in improving patient outcomes.
  • To highlight the integration of these strategies with optimal medical management.

Main Methods:

  • Review of recent clinical trials and therapeutic modalities for heart failure.
  • Analysis of surgical techniques including ventricular remodeling and mitral valve repair.
  • Evaluation of device therapies such as ventricular assist devices, ICDs, and CRT.

Main Results:

  • Recent trials demonstrate significant improvements in cardiac endpoints, HF symptoms, and survival with alternative therapies.
  • Surgical and device interventions, when combined with optimal medical management, offer viable options for advanced HF.
  • These therapies are increasingly utilized in an aging and complex patient population.

Conclusions:

  • Alternative surgical and device therapies represent crucial advancements in managing advanced heart failure.
  • These strategies offer improved outcomes for patients ineligible for cardiac transplantation.
  • Further research is needed to determine the long-term cost-effectiveness of these emerging heart failure treatments.

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