Advances in heart failure surgery

Heart failure is a major public health problem in the USA and in most Western countries. Nearly 5 million patients in the USA have heart failure with approximately 500,000 patients being diagnosed for the first time each year. Medical therapy is the first-line treatment, and surgery is considered when medical therapy fails or a clear mechanical cause of heart failure is identified and deemed correctable. Current surgical options include coronary revascularization, surgical correction of mitral regurgitation, left ventricular reconstruction, transmyocardial laser revascularization, ventricular assist devices, passive ventricular restraint devices, and cardiac transplantation. While a full discussion of cardiac transplantation is beyond the scope of this article, the other commonly performed procedures will be reviewed.