title: [Surgery in advanced heart failure].
abstract: BACKGROUND
  ACE inhibitors and beta blockers have reduced morbidity and mortality from chronic heart failure significantly during the last years. Apart from medical therapy several surgical strategies for the treatment of heart failure are available.
  Surgical treatment should be directed towards the underlying etiology and mechanisms. To decide for a special surgical therapy indications and contraindications must be considered.
  
  
  METHODS
  The surgical therapy of heart failure can be performed with or without replacement of the heart. Especially concerning the organ-conserving techniques there has been significant progress during the last years: left ventricular aneurysmectomy, mitral valve surgery as well as high-risk coronary artery bypass surgery and electrostimulating procedures. Concerning heart replacement therapy, cardiac transplantation with a 10-year survival of 50% still remains superior to all available mechanical devices at the moment.
mesh_terms: D018421:Cardiomyoplasty; D001026:Coronary Artery Bypass; D006322:Heart Aneurysm / Q000150:complications / Q000401:mortality / Q000601:surgery; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D008943:Mitral Valve / Q000601:surgery; D011183:Postoperative Complications / Q000401:mortality; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000401:mortality / Q000601:surgery*
vernacular_title: Chirurgie bei fortgeschrittener Herzinsuffizienz.