Surgical Therapy for Heart Failure

( t h s fter a meeting of the American College of Cardiolgy in 2003, the cover of US News and World Report oldly proclaimed: “The end of heart disease.” The edia frenzy after one of the national cardiology eetings is always interesting to observe. The latereaking trials of pharmacology, drug-eluting coroary stents, and percutaneous heart valves conspire to ake even the busiest cardiothoracic surgeon think of is or her own professional future. But amid our cariologic colleagues’ excitement over the “vanishing calpel” are some sobering statistics (Table 1). Cariovascular disease remains the leading cause of death n the US. Ischemic heart disease accounts for a large ortion of these deaths. Although the number of paients dying acutely from myocardial infarction has ecreased nearly 30% in the last 2 decades, the numer of patients dying from heart failure (HF) has douled. Despite improving medical therapy, many of hese patients continue to have functional decline and ltimately die. Management of HF, as such, has volved into a steadily growing discipline. This review ill discuss the role of surgical therapy for treating the nlarging population of patients with HF.