Non-transplant surgery for heart failure

Abstract

The scope of heart failure surgery is developing rapidly but relies increasingly upon expensive diagnostic techniques and mechanical circulatory support. The major issues are not ethical but economic. New miniature axial flow and centrifugal blood pumps are emerging from bioengineering laboratories and will eventually be used as frequently for heart failure as is the pacemaker for rhythm problems. In the future, new drugs, gene therapy, and autogenous myocyte culture will promote left ventricular repair during circulatory support, thereby freeing the limited number of donor organs for younger complex congenital hearts.