title: [Management of advanced or refractory heart failure].
abstract: Advanced heart failure, also be defined as stage D heart failure, characterized by advanced structural heart disease and marked symptoms of heart failure at rest despite dietary modification, salt restriction and maximal medical therapy including ACE inhibitors, angiotensin II receptor blockers, digitalics, diuretics and beta blockers. These patients require frequent hospitalizations and specialized interventions such as heart transplantation, implantation of mechanical assistance devices, continuous intravenous inotropic therapy to palliate symptoms, or continued terminal care.
authors.affiliation: Servicio de Cardiología, Hospital Juan Canalejo, A Coruña, Spain. MCreLei@canalejo.org
authors.forename: María G
authors.initials: MG
authors.lastname: Crespo Leiro
authors.forename: María J
authors.initials: MJ
authors.lastname: Paniagua Martín
mesh_terms: D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006333:Heart Failure / Q000188:drug therapy* / Q000601:surgery*; D016027:Heart Transplantation / Q000592:standards; D006353:Heart-Assist Devices / Q000592:standards; D006801:Humans; D017410:Practice Guidelines as Topic
chemical_list: D002317:Cardiovascular Agents
vernacular_title: Tratamiento de la insuficiencia cardíaca refractaria o avanzada.