Surgical restoration of the failing left ventricle.

As life expectancy increases in the Western world, heart failure (HF) is a major public health concern. Many patients with markedly reduced left ventricular ejection fraction can survive for years with reasonable functional capacity. Transplant-listed patients (LV) with ischemic heart disease who do not receive a donor organ may have a 3- to 4-year survival that equates with those transplanted. Thus, it is difficult to decide when to commit a patient with ischemic cardiomyopathy to transplantation unless supported by a LV assist device for cardiogenic shock. At the same time, the availability of donor organs is decreasing, with only 2000 per year in the United States and less than 300 in the United Kingdom. Consequently, there is a need to evaluate new surgical options for the deteriorating HF patient.