Non-transplant Options in Advanced Heart Failure: Emergent Need for Guidelines ?

Advances in revascularization techniques along with its timeliness has significantly prolonged survival in Coronary Artery Disease. Progressive heart failure is one of the complications which persists in a large scale. The challenges of surgical revascularization in such patients with left ventricular dysfunction are daunting, necessitating short cross-clamp and cardio-pulmonary bypass times. Associated co-morbidities like renal dysfunction, low cardiac output state and pulmonary vascular obstructive disease are additional significant deterrents to surgical success. In the situation where transplant options are limited, viability of high-risk surgical revascularization may need radical re-thinking.