53
Table 34. Recommendations for Surgical/Percutaneous/
Transcatheter Interventional Treatments of HF
Recommendation COR LOE
CABG or percutaneous intervention is indicated for HF patients
on GDMT with angina and suitable coronary anatomy, especially
significant le main stenosis or le main equivalent
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
