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Updated: Aug 8, 2026

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
[Conventional surgery for congestive heart failure]
Michele De Bonis1, Elisabetta Lapenna, Giovanni La Canna
1Cattedra di Cardiochirurgia, Università "Vita e Salute" San Raffaele, Divisione di Cardiochirurgia, Ospedale San Raffaele, Milano. michele.debonis@hsr.it
Insights
Conventional surgery offers a vital alternative for advanced heart failure when transplantation is not feasible. This review details surgical interventions for dilated cardiomyopathy, improving outcomes for many patients.
Area of Science:
- Cardiology
- Cardiac Surgery
- Heart Failure Management
Background:
- Congestive heart failure (CHF) is a significant global health issue, with increasing incidence of end-stage dilated cardiomyopathy.
- Heart transplantation is effective but limited by donor availability, necessitating alternative treatments.
- Conventional surgical procedures are gaining importance for managing advanced heart failure.
Purpose of the Study:
- To review surgical strategies for end-stage heart failure due to dilated cardiomyopathy.
- To present institutional experience with over 500 patients undergoing conventional cardiac surgery.
- To discuss indications, outcomes, and future directions for surgical interventions in heart failure.
Main Methods:
- Review of surgical interventions in patients with advanced dilated cardiomyopathy.
- Procedures included myocardial revascularization, left ventricular restoration, mitral valve repair, and atrial fibrillation ablation.
- Analysis of indications, results, and controversial aspects of surgical management.
Main Results:
- Conventional surgical procedures are effective in managing multifactorial heart failure.
- Specific interventions like left ventricular restoration and mitral valve repair show significant impact.
- Surgical ablation for atrial fibrillation addresses a common comorbidity in heart failure patients.
Conclusions:
- Conventional surgical treatments are crucial for patients with advanced dilated cardiomyopathy ineligible for heart transplantation.
- Optimized surgical techniques offer viable options for improving quality of life and outcomes.
- Further research and refinement of surgical approaches are warranted for heart failure management.
Abstract:
Congestive heart failure is a major public health problem in western countries. Although substantial efforts have been made in the last decades in the prevention, diagnosis and treatment of cardiovascular disease, the incidence of end-stage dilated cardiomyopathy is still increasing. Heart transplantation represents the most effective therapy in this setting, but due to shortage of donors, it remains a realistic option just for a very small number of patients. Therefore, conventional surgical treatment for end-stage heart disease has gained increasing attention in recent years and a variety of surgical interventions have been improved or optimized to manage the multifactorial pathophysiology of the heart failure picture. The aim of this review is to report our experience with more than 500 patients with advanced dilated cardiomyopathy, treated with conventional surgical procedures such as myocardial revascularization, left ventricular restoration, mitral valve repair and surgical ablation of atrial fibrillation. Indications, results, controversial issues and future perspectives will be discussed.
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