Surgical Treatment of Heart Failure.

More than 5 million Americans suffer from heart failure and more than 250,000 die annually. Cardiac surgery, as applied to advanced heart failure, has evolved significantly in the past 50 years. Current therapeutic interventions are focused on the appropriate assessment of myocardial dysfunction as a means to select the right patient for the appropriate procedure using state-of-the-art myocardial viability testing and metabolic testing to determine candidacy for conventional interventions, mechanical devices, or transplant. Advances in mechanical circulatory support with more efficient and less morbid ventricular assist devises offer the potential to change the trajectory of this growing epidemiologic dilemma.