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Mitral Valve Repair

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Management of Heart Failure

Abstract

Congestive heart failure (CHF) has become an international heath care problem and it is one of the world’s leading causes of hospitalization and mortality. In the United States alone, 4.9 million people (2.3 % of total population) are suffering from heart failure with 550,000 new cases diagnosed each year. Hospital discharge for CHF increased from 377,000 in 1979 to 970,000 in 2002, an increase of 157 %. Estimated health expenditures amount to $ 25.3 billion in 2005 [1]. In spite of these, only 2,100 of the 53,000 patients who die annually are offered transplantation, which many consider to be the standard treatment for selected patients with severe CHF and end-stage heart disease. Transplantation is severely limited by the paucity of donor availability and enormous cost. The inapplicability in the older patient or those with comorbid medical conditions as well as relatively fixed donor pool suggest that transplantation will likely never have a major epidemiological impact [2]. Treatment with mechanical circulatory support devices dances on the horns of the same dilemma. Consequently, despite improvements with medical management, 1 year, 3 year and 5-year survival after hospitalization from CHF have been reported at approximately 80–60 %, 50 % and 40–20 % respectively, which is worse than that of most cancers [3–7].

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Correspondence to Jaishankar Raman MBBS, MMed, FRACS, PhD .

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Hill, A.C., Beaver, T.M., Raman, J. (2016). Mitral Valve Repair. In: Raman, J. (eds) Management of Heart Failure. Springer, London. https://doi.org/10.1007/978-1-4471-4279-9_9

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