Dynamic cardiomyoplasty in patients with end-stage heart failure: anaesthetic considerations

Perioperative Treatment of Congestive Heart Failure

Congestive heart failure is a common disease that affects 5 million people and will continue to increase in prevalence as the population ages. Estimates of its prevalence in patients presenting for vascular surgery range up to 50%. It has been consistently shown to be associated with increased mortal ity after vascular surgery. The anesthesiologist's contact with this disease entity will increase as well. Little has changed in the treatment of this disease until recently. Many new developments have occurred in the pathophysiology and the treatment of this age-old disease. This article re views developments in the pathophysiology, which have resulted in a new understanding and a complete revision of the recommendations for the treatment of heart failure as well as some modalities that hold promise for the future.