Traitement chirurgical de l’insuffisance cardiaque (hors transplantation)

Cardiac transplant remains the gold standard in the treatment of end-stage cardiac insufficiency. However, a great gap between the number of available grafts and the number of patients eligible to the waiting list for cardiac transplant leads, for some of them, to consider a surgical alternative in order to improve their clinical condition and delay as much as possible the transplant schedule. The goal is to treat surgically one or several of the lesions that influence the cardiac insufficiency. It may consist in valvular surgery, coronary surgery or a combination of both, ventricular remodelling or cardiomyoplasty. Coronary revascularisation results in spectacular improvement provided it concerns myocardial zones of which the viability has been demonstrated by thallium scintigraphy or stress echocardiography.