Comprehensive Interventions in End-Stage Cardiomyopathy: Mechanical Circulatory Support and Heart Transplantation

Abstract

This chapter provides a comprehensive exploration of the primary indications for employing mechanical circulatory support and heart transplantation in the treatment of end-stage cardiomyopathy. It emphasizes the specific types of support, patient selection criteria, optimal timing for intervention, and the prevalent varieties of mechanical assistance devices currently utilized. The chapter delves into nuanced patient outcomes concerning both temporary and long-term support, while also offering a succinct overview of the evolving perspectives within this field. Heart transplantation serves as the ultimate resource for cardiomyopathy patients for whom conventional medical therapy has proven ineffective. This section centers on delineating the indications and contraindications for heart transplantation, emphasizing patient care protocols, early and late postoperative complications, and the future trajectories in this domain. A critical analysis scrutinizes and compares the efficacy and applicability of mechanical assistance against heart transplantation within this patient cohort. Given the intricacies of surgical interventions for cardiomyopathy, the chapter outlines prospects, encompassing advancements such as xenotransplantation and the integration of new mechanical assist devices into the evolving landscape of treatments.