Revascularization in Cardiogenic Shock and Advanced Heart Failure.
Curr Treat Options Cardiovasc Med
; 21(1): 4, 2019 Feb 07.
Article
en En
| MEDLINE
| ID: mdl-30729357
ABSTRACT
PURPOSE OF REVIEW Ischemic heart disease is the most common cause of heart failure with systolic dysfunction. The progressive course of heart failure characterized by increasing levels of care and worsening quality of life often indicates an advanced stage. Similarly, cardiogenic shock remains a major clinical problem with prohibitively high mortality rates despite major advances in clinical care. Here, we review the current treatment options and available data for revascularization in patients with ischemic cardiomyopathy, advanced heart failure, and cardiogenic shock. We also explore the emerging role of Interventional Heart Failure specialist within the Heart Team. RECENT FINDINGS:
Although guideline-directed medical therapy remains the cornerstone treatment strategy for patients with advanced heart failure, coronary revascularization is sometimes indicated. There is a relatively paucity of evidence regarding different revascularization strategies and the use of acute mechanical circulatory support in patients with advanced heart failure and in those presenting with cardiogenic shock. A deep understating of the physiologic and hemodynamic effects of different acute mechanical support platforms is of paramount importance in preparation for revascularization in these patients. The decision regarding revascularization in patients with coronary artery disease in the setting of left ventricular dysfunction remains challenging. Clinical decision-making in these cases requires interdisciplinary discussion and assessment of the potential long-term survival derived from surgical revascularization against its higher perioperative risk.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Tipo de estudio:
Guideline
/
Prognostic_studies
/
Qualitative_research
Aspecto:
Patient_preference
Idioma:
En
Revista:
Curr Treat Options Cardiovasc Med
Año:
2019
Tipo del documento:
Article
País de afiliación:
Estados Unidos