Related Experiment Video
Updated: Jun 20, 2026
07:27
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Surgical treatments for advanced heart failure
Mani A Daneshmand1, Carmelo A Milano
1Department of General and Thoracic Surgery, Duke University Medical Center, DUMC 3043, Durham, NC 27710, USA.
The Surgical Clinics of North America
|September 29, 2009
Summary
Advanced heart failure patients often have poor survival with medical treatment alone. Surgical interventions like ventricular restoration, ventricular assist devices, and heart transplantation offer improved outcomes for these critical patients.
Area of Science:
- Cardiology
- Cardiovascular Surgery
Background:
- Advanced heart failure (HF) patients have dismal survival rates with medical management alone.
- Surgical treatments offer significant benefits for this patient cohort.
- Left ventricular aneurysms (LVAs) and ischemic cardiomyopathy are common in advanced HF.
Purpose of the Study:
- To review surgical treatments for advanced heart failure.
- To focus on left ventricular aneurysm repair, surgical ventricular restoration, ventricular assist devices, and cardiac transplantation.
- To discuss indications, technical features, and postoperative management.
Main Methods:
- Literature review of surgical techniques for advanced heart failure.
- Focus on left ventricular aneurysm repair and surgical ventricular restoration.
- Evaluation of ventricular assist devices and cardiac allograft transplantation.
Main Results:
- Surgical ventricular restoration techniques have broadened application in ischemic cardiomyopathy.
- Various surgical options exist for advanced heart failure patients.
- Intraoperative and postoperative management strategies are crucial for successful outcomes.
Conclusions:
- Surgical interventions are vital for improving survival in advanced heart failure.
- A comprehensive understanding of indications and techniques is essential for optimal patient care.
- Ventricular restoration, assist devices, and transplantation represent key treatment modalities.
Related Concept Videos
01:22Heart Failure VI: Adjunct Therapies
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
01:30Heart Failure V: Medical Management
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
01:29Cardiomyopathy V: Interprofessional Care
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
01:30Heart Failure IV: Classification and Diagnostic Evaluation
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
01:30Cardiomyopathy II: Dilated Cardiomyopathy
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...