Treatment
Table 27. Recommendations for Surgical/Percutaneous/
Transcatheter Interventional Treatments of HF
Recommendation
COR
LOE
I
C
CABG to improve survival is reasonable in patients with mild
to moderate LV systolic dysfunction and significant multivessel
CAD or proximal LAD stenosis when viable myocardium is
present
IIa
B
CABG or medical therapy is reasonable to improve morbidity
and mortality for patients with severe LV dysfunction (EF
<35%), HF, and significant CAD
IIa
B
Surgical aortic valve replacement is reasonable for patients with
critical aortic stenosis and a predicted surgical mortality of ≤10%
IIa
B
Transcatheter aortic valve replacement is reasonable for patients
with critical aortic stenosis who are deemed inoperable
IIa
B
CABG may be considered in patients with ischemic heart disease,
severe LV systolic dysfunction, and operable coronary anatomy
whether or not viable myocardium is present
IIb
B
Transcatheter mitral valve repair or mitral valve surgery for
functional mitral insufficiency is of uncertain benefit
IIb
B
Surgical reverse remodeling or LV aneurysmectomy may
be considered in HFrEF for specific indications including
intractable HF and ventricular arrhythmias
IIb
B
CABG or percutaneous intervention is indicated for HF patients
on GDMT with angina and suitable coronary anatomy, especially
significant left main stenosis or left main equivalent
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