[Management of end-stage heart failure].
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.
Schnetzler
Bruno
B
Service de transplantation, Hôpitaux universitaires de Genève, 1211 Genève 14. bruno.schnetzler@hcuge.ch
Reverdin
Stéphane
S
Sunthorn
Henri
H
Kalangos
Afksendiyos
A
Sigwart
Ulrich
U
D006333:Heart Failure / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D018570:Risk Assessment