Surgical Options in Heart Failure

Abstract Heart failure (HF) continues to be a leading cause of morbidity and mortality. Despite optimized medical therapy (OMT), a significant portion of patients will progress to advanced stages of HF to which OMT is no longer sufficient. Myocardial revascularization remains a cornerstone for patients with ischemic cardiomyopathy, with evidence showing significant survival benefits over OMT alone. Valvular interventions address secondary mitral and aortic disease that contribute to declining cardiac function. For patients with end-stage failure or cardiogenic shock, mechanical circulatory support devices and ventricular-assist devices serve as bridge or destination therapy.