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Updated: Jun 22, 2026
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Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Management of severe heart failure
Shinya Hiramitsu1, Kenji Miyagishima, Hisashi Kimura
1Cardiology, Hiramitsu Heart Clinic, Minami-ku, Nagoya 457-0047, Japan.
Summary
Hospitalized heart failure (HF) patients require tailored treatments, including diuretics, ACE inhibitors/ARBs, and beta-blockers. For severe cases unresponsive to medical therapy, heart transplantation is a last resort, though access remains limited.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Heart failure (HF) encompasses new-onset acute HF and exacerbations of chronic HF (CHF).
- Therapy for acute HF post-myocardial infarction necessitates addressing both acute and convalescent phases, focusing on left ventricular (LV) remodeling.
- Evolving CHF treatment strategies prioritize cardiac rest over solely enhancing LV contractility.
Purpose of the Study:
- To outline current therapeutic strategies for hospitalized heart failure patients.
- To emphasize the role of specific drug classes and non-pharmacological interventions.
- To discuss the role and limitations of heart transplantation in advanced HF management.
Main Methods:
- Review of standard medical therapies for acute and chronic heart failure.
- Discussion of non-pharmacological treatment options for refractory HF.
- Analysis of heart transplantation outcomes and accessibility in a hospital setting.
Main Results:
- Routine HF management typically involves a combination of diuretics, ACE inhibitors/ARBs, and beta-blockers, with beta-blockers being crucial.
- Non-pharmacological therapies are considered for HF unresponsive to medical treatment.
- Heart transplantation is a necessary option for end-stage HF, though availability and patient survival pre-transplant present significant challenges.
Conclusions:
- Optimal medical therapy for HF involves a multi-drug regimen, including beta-blockers.
- Non-pharmacological interventions and heart transplantation are vital for managing advanced or refractory HF.
- While heart transplantation is a possibility, its limited availability impacts patient outcomes, particularly in regions like Japan.
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