Surgical management of heart failure.
Surgical therapy for congestive heart failure can offer gratifying results in selected elderly patients. Several trials have shown a survival advantage for surgical revascularization compared with medical therapy in the treatment of ischemic cardiomyopathy. Aortic valve replacement is highly effective in treating elderly patients with heart failure caused by severe aortic stenosis, and stentless aortic valves seem to provide a survival advantage in elderly patients with low-gradient aortic stenosis. Mitral valve repair with or without coronary revascularization has been used successfully in patients with severe mitral regurgitation. Transplantation is a viable but rarely used option for elderly patients with congestive heart failure. Totally implantable ventricular assist devices are an exciting new option for elderly patients with congestive heart failure who are not heart transplantation candidates.
Slaughter
M S
MS
Mechanical Assist Device Program and Surgery for Congestive Heart Failure, Christ Hospital and Medical Center, Oak Lawn, Illinois, USA.
Ward
H B
HB
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000601:surgery; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000601:surgery; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D017052:Hospital Mortality; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery; D009204:Myocardial Revascularization; D016019:Survival Analysis; D016896:Treatment Outcome; D020257:Ventricular Remodeling