[Myocardial revascularization and ischemic heart failure].
Ischaemic heart failure is the cause of an increased number of hospital admissions and death rate. In severe heart failure and cardiogenic shock, coronary reperfusion associated or not with aortic balloon pump counter-pulsation, seems to be beneficial. Moreover, it has recently shown that coronary bypass surgery may be a reasonable alternative to cardiac transplantation in coronary patients with severe heart failure. In the chronic phase, two physiopathological conditions have been proposed to explain the mechanism of ischaemic left-ventricular dysfunction: myocardial hibernation and stunning. Only hibernation requires revascularisation to avoid irreversible myocardial damage. The CASS group and others have demonstrated a real benefit from surgery although the operative risk is greater. Angioplasty has also been shown to be effective in terms of primary success with a relatively low complication rate. Compared one with another, angioplasty seems to provide better immediate results whereas surgery is associated with more long-term benefits. Myocardial revascularisation is therefore part of the therapeutic arsenal in cases of ischaemic heart failure.
D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications / Q000401:mortality / Q000601:surgery*; D009204:Myocardial Revascularization; D012770:Shock, Cardiogenic; D015996:Survival Rate; D016277:Ventricular Function, Left
Revascularisation myocardique et insuffisance cardiaque ischémique.