Despite all efforts and success in medical treatment, the incidence
of (end-stage) chronic heart failure is increasing. Cardiac
transplantation remains the only definite option; however, due to
the shortage of donor organs, very few people benefit. Therefore,
surgery of end-stage heart failure using conventional techniques
has gained new interest after the introduction of the Batista
operation. However, a clear surgical identification of the patients
to be included in this group is lacking. Left ventricular reduction
surgery as well as reduction of the base of the heart using mitral
annuloplasty or mitral valve replacement, sparing both papillary
muscles, is used in selected patients with satisfying results and
good survival. Long-term mechanical support with subsequent
surgical remodeling or supporting myoplasty may result in a
beneficial alternative to heart transplantation.
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