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Surgical treatment for severe heart failure: recent progress in treatment strategy and its present status in Japan

Motonobu Nishimura1

  • 1Division of Organ Regeneration Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.

Yonago Acta Medica
|September 14, 2013
PubMed

Insights

For severe heart failure unresponsive to medication, surgical options like left ventriculoplasty and ventricular assist devices are crucial alternatives to heart transplantation due to donor limitations.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Technology

Background:

  • Chronic intractable heart failure, often caused by ischemic cardiomyopathy (ICM) or dilated cardiomyopathy (DCM), severely impairs left ventricular function.
  • Current treatments for advanced heart failure include heart transplantation, but donor scarcity limits its widespread application.
  • Alternative surgical interventions are essential for managing patients with severe left ventricular hypofunction.

Purpose of the Study:

  • To provide an overview of current surgical treatments for severe heart failure.
  • To discuss left ventriculoplasty, heart transplantation, and ventricular assist devices (VADs).
  • To highlight recent advancements in VAD technology for heart failure management.

Main Methods:

  • Review of current literature and clinical practices regarding surgical interventions for heart failure.
  • Analysis of the efficacy and limitations of left ventriculoplasty, heart transplantation, and VADs.
  • Discussion of the evolving landscape of mechanical circulatory support.

Main Results:

  • Heart transplantation remains a primary option but is limited by donor availability.
  • Left ventriculoplasty offers a surgical alternative for specific heart failure etiologies.
  • Ventricular assist devices have demonstrated significant progress and improved outcomes in managing advanced heart failure.

Conclusions:

  • Surgical interventions, including left ventriculoplasty and VADs, are vital for patients with end-stage heart failure unresponsive to medical therapy.
  • Advancements in VAD technology are expanding treatment options and improving quality of life for heart failure patients.
  • A multi-faceted approach combining medical, surgical, and device-based therapies is necessary for optimal heart failure management.

Keywords:
heart transplantleft ventriculoplastyventricular assist device

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