Long-term management of end-stage heart failure.
Best Pract Res Clin Anaesthesiol
; 31(2): 153-166, 2017 Jun.
Article
en En
| MEDLINE
| ID: mdl-29110789
ABSTRACT
End-stage heart failure manifests as severe and often relentless symptoms that define the clinical syndrome of heart failure, namely congestion and hypoperfusion. These patients suffer from dyspnea, fatigue, abdominal discomfort, and ultimately cardiac cachexia. Renal and hepatic dysfunction frequently further complicates the process. Recurrent hospitalizations, cardiac arrhythmias, and intolerance to standard heart failure therapies are common as the disease progresses. Management focuses on controlling symptoms, correcting precipitants, avoiding triggers, and maximizing therapies with demonstrable survival benefit. Among appropriate candidates, advanced therapies such as orthotopic heart transplant (OHT) can significantly extend survival and improve the quality of life. Left ventricular assist devices have been used with increasing frequency as a bridge to OHT or as a destination therapy in appropriately selected candidates where they have a demonstrable mortality benefit over medical therapy. Importantly, a multidisciplinary patient-centered approach is crucial when considering these advanced therapies.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
6_cardiovascular_diseases
/
6_other_circulatory_diseases
Asunto principal:
Manejo de la Enfermedad
/
Insuficiencia Cardíaca
Aspecto:
Patient_preference
Límite:
Humans
Idioma:
En
Revista:
Best Pract Res Clin Anaesthesiol
Asunto de la revista:
ANESTESIOLOGIA
Año:
2017
Tipo del documento:
Article