Surgery for Heart Failure: Now Something for Everyone?

For the past 50 years cardiac surgery has been in a continuous state of flux. Nontransplant heart failure surgery is an expanding field at a time when medical treatment and cardiac resynchronization therapy have recognized limits. Although donor hearts can be supplied to only a tiny minority of patients who have heart failure, other surgical options may soon provide symptomatic relief for the majority. Left ventricular restoration surgery is predicated on the well-defined relationship between cardiac shape, volume, and function. The recent remarkable developments in blood pump bioengineering provide an alternative approach and a platform on which to base genetic or stem cell therapies.