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Supportive Care in Heart Failure$
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James Beattie and Sarah Goodlin

Print publication date: 2008

Print ISBN-13: 9780198570288

Published to Oxford Scholarship Online: November 2011

DOI: 10.1093/acprof:oso/9780198570288.001.0001

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Advanced Heart Failure: The Role of the Surgeon

Advanced Heart Failure: The Role of the Surgeon

(p.87) Chapter 6 Advanced Heart Failure: The Role of the Surgeon
Supportive Care in Heart Failure

Stephen Westaby

Gabriele B. Bertoni

Oxford University Press

This chapter deals with the state of knowledge on the role of the surgeon on the advanced heart failure (HF). It begins by addressing how the HF patient reaches the surgeon. The surgeon's role is to determine which operation or combination of surgical procedures best suits an individual and whether the operation can be performed with acceptable risk and likelihood of benefit given the overall condition of the patient. It also considers how the surgical strategy is determined. The potential surgical procedure, its risks, and likely benefit can be discussed with the patient. It then describes the decision-making in patients with ischaemic cardiomyopathy, testing for myocardial viability, outcome after non-transplant surgery for ischaemic cardiomyopathy, improvement in myocardial function, left-ventricular restoration surgery, mitral valve repair in ischaemic cardiomyopathy, and the role of stem cells. Next, it discusses the decision-making in patients with idiopathic dilated cardiomyopathy, mitral valve repair, external cardiac constraint, partial left ventriculectomy (Batista operation), and mechanical left-ventricular unloading in dilated cardiomyopathy. The lifetime circulatory support as a primary treatment for advanced HF and the patient selection for lifetime circulatory support are explained as well.

Keywords:   heart failure, surgeon, ischaemic cardiomyopathy, stem cells, idiopathic dilated cardiomyopathy, Batista operation, left-ventricular restoration surgery, lifetime circulatory support

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