Heart Failure

Heart Failure - 2017 Update

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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

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