title: [Management of end-stage heart failure].
abstract: Non-medical approaches to end-stage heart failure (ESHF) include heart transplantation, but also implantable cardioverter-defibrillators, cardiac resynchronization therapy and ventricular assist devices. These techniques might be used as a bridge to transplant, as a bridge to recovery or as destination therapy. Optimal medical therapy of ESHF should include an angiotensin-converting enzyme inhibitor, a beta-blocker and spironolactone. Risk stratification in ESHF allows to determine the individual prognosis of each patient with parameters such as echocardiographic criteria, peak exercise oxygen consumption, or plasma BNP levels. Heart transplantation is to be considered if the individual prognosis obtained after stratification is worse than the expected survival of transplant recipients.
authors.affiliation: Service de transplantation, Hôpitaux universitaires de Genève, 1211 Genève 14. bruno.schnetzler@hcuge.ch
authors.forename: Bruno
authors.initials: B
authors.lastname: Schnetzler
authors.forename: Stéphane
authors.initials: S
authors.lastname: Reverdin
authors.forename: Henri
authors.initials: H
authors.lastname: Sunthorn
authors.forename: Afksendiyos
authors.initials: A
authors.lastname: Kalangos
authors.forename: Ulrich
authors.initials: U
authors.lastname: Sigwart
mesh_terms: D006333:Heart Failure / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D018570:Risk Assessment