Congestive heart failure AHA recommendations Surgical/Percutaneous/Transcather Interventional Treatments of HF

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ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
Hospitalized Patient
Patients With a Prior MI
Sudden Cardiac Death Prevention
Surgical/Percutaneous/Transcather Interventional Treatments of HF
Patients at high risk for developing heart failure (Stage A)
Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)
Patients with current or prior symptoms of heart failure (Stage C)
Patients with refractory end-stage heart failure (Stage D)
Coordinating Care for Patients With Chronic HF
Quality Metrics/Performance Measures

Implementation of Practice Guidelines

Congestive heart failure end-of-life considerations

Specific Groups:

Special Populations
Patients who have concomitant disorders
Obstructive Sleep Apnea in the Patient with CHF
NSTEMI with Heart Failure and Cardiogenic Shock

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Mahmoud Sakr, M.D. [3] Edzel Lorraine Co, DMD, MD[4]

2013 ACCF/AHA Guideline/2009 ACC/AHA Focused Update and 2005 Guidelines for the Diagnosis and Management of Heart Failure in the Adult (DO NOT EDIT) [1][2]

Surgical/Percutaneous/Transcatheter Interventional Treatments of HF (DO NOT EDIT) [1][2]

Class I
"1. Coronary artery revascularization via CABG or percutaneous intervention is indicated for patients (HFpEF and HFrEF) on GDMT with angina and suitable coronary anatomy, especially for a left main stenosis (>50%) or left main equivalent disease.[3][4][5][6] (Level of Evidence: C) "
Class IIa
"1. CABG to improve survival is reasonable in patients with mild to moderate LV systolic dysfunction (EF 35% to 50%) and significant (≥70% diameter stenosis) multivessel CAD or proximal left anterior descending coronary artery stenosis when viable myocardium is present in the region of intended revascularization.[6][7] (Level of Evidence: B) "
"2. CABG or medical therapy is reasonable to improve morbidity and cardiovascular mortality for patients with severe LV dysfunction (EF <35%), HF, and significant CAD.[8][9] (Level of Evidence: C) "
"3. Surgical aortic valve replacement is reasonable for patients with critical aortic stenosis and a predicted surgical mortality of no greater than 10%.[10] (Level of Evidence: B) "
"4. Transcatheter aortic valve replacement after careful candidate consideration is reasonable for patients with critical aortic stenosis who are deemed inoperable.[11] (Level of Evidence: B) "
"5. Surgical reverse remodeling or LV aneurysmectomy may be considered in carefully selected patients with HFrEF for specific indications, including intractable HF and ventricular arrhythmias. [12] (Level of Evidence: B) "
Class IIb
"1. CABG may be considered with the intent of improving survival in patients with ischemic heart disease with severe LV systolic dysfunction (EF <35%) and operable coronary anatomy whether or not viable myocardium is present.[13][8] (Level of Evidence: B) "
"2. Transcatheter mitral valve repair or mitral valve surgery for functional mitral insufficiency is of uncertain benefit and should only be considered after careful candidate selection and with a background of GDMT.[14][15] (Level of Evidence: B) "

Vote on and Suggest Revisions to the Current Guidelines

  • The Living Guidelines: Diagnosis and Management of Chronic Heart Failure | The CHF Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines

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References

  1. ↑ 1.0 1.1 1.2 Yancy CW, Jessup M, Bozkurt B, Masoudi FA, Butler J, McBride PE; et al. (2013). "2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. doi:10.1016/j.jacc.2013.05.019. PMID 23747642.
  2. ↑ 2.0 2.1 2.2 Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119 (14):1977-2016.DOI:10.1161/CIRCULATIONAHA.109.192064 PMID:19324967
  3. ↑ Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG; et al. (2011). "2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Developed in collaboration with the American Association for Thoracic Surgery, Society of Cardiovascular Anesthesiologists, and Society of Thoracic Surgeons". J Am Coll Cardiol. 58 (24): e123–210. doi:10.1016/j.jacc.2011.08.009. PMID 22070836.
  4. ↑ Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B; et al. (2011). "2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions". J Am Coll Cardiol. 58 (24): e44–122. doi:10.1016/j.jacc.2011.08.007. PMID 22070834.
  5. ↑ Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP; et al. (2012). "2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 60 (24): e44–e164. doi:10.1016/j.jacc.2012.07.013. PMID 23182125.
  6. ↑ 6.0 6.1 Caracciolo EA, Davis KB, Sopko G, Kaiser GC, Corley SD, Schaff H; et al. (1995). "Comparison of surgical and medical group survival in patients with left main coronary artery disease. Long-term CASS experience". Circulation. 91 (9): 2325–34. PMID 7729018.
  7. ↑ "Eleven-year survival in the Veterans Administration randomized trial of coronary bypass surgery for stable angina. The Veterans Administration Coronary Artery Bypass Surgery Cooperative Study Group". N Engl J Med. 311 (21): 1333–9. 1984. doi:10.1056/NEJM198411223112102. PMID 6333636.
  8. ↑ 8.0 8.1 Velazquez EJ, Lee KL, Deja MA, Jain A, Sopko G, Marchenko A; et al. (2011). "Coronary-artery bypass surgery in patients with left ventricular dysfunction". N Engl J Med. 364 (17): 1607–16. doi:10.1056/NEJMoa1100356. PMC 3415273. PMID 21463150. Review in: Evid Based Med. 2012 Dec;17(6):178-9 Review in: Ann Intern Med. 2011 Aug 16;155(4):JC2-9
  9. ↑ Cleland JG, Calvert M, Freemantle N, Arrow Y, Ball SG, Bonser RS; et al. (2011). "The Heart Failure Revascularisation Trial (HEART)". Eur J Heart Fail. 13 (2): 227–33. doi:10.1093/eurjhf/hfq230. PMID 21156659.
  10. ↑ Smith CR, Leon MB, Mack MJ, Miller DC, Moses JW, Svensson LG; et al. (2011). "Transcatheter versus surgical aortic-valve replacement in high-risk patients". N Engl J Med. 364 (23): 2187–98. doi:10.1056/NEJMoa1103510. PMID 21639811.
  11. ↑ Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG; et al. (2010). "Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery". N Engl J Med. 363 (17): 1597–607. doi:10.1056/NEJMoa1008232. PMID 20961243. Review in: Evid Based Med. 2011 Jun;16(3):74-5
  12. ↑ Jones RH, Velazquez EJ, Michler RE, Sopko G, Oh JK, O'Connor CM; et al. (2009). "Coronary bypass surgery with or without surgical ventricular reconstruction". N Engl J Med. 360 (17): 1705–17. doi:10.1056/NEJMoa0900559. PMC 3265934. PMID 19329820.
  13. ↑ Alderman EL, Fisher LD, Litwin P, Kaiser GC, Myers WO, Maynard C; et al. (1983). "Results of coronary artery surgery in patients with poor left ventricular function (CASS)". Circulation. 68 (4): 785–95. PMID 6352078.
  14. ↑ Feldman T, Foster E, Glower DD, Glower DG, Kar S, Rinaldi MJ; et al. (2011). "Percutaneous repair or surgery for mitral regurgitation". N Engl J Med. 364 (15): 1395–406. doi:10.1056/NEJMoa1009355. PMID 21463154.
  15. ↑ Franzen O, van der Heyden J, Baldus S, Schlüter M, Schillinger W, Butter C; et al. (2011). "MitraClip® therapy in patients with end-stage systolic heart failure". Eur J Heart Fail. 13 (5): 569–76. doi:10.1093/eurjhf/hfr029. PMID 21471146.
  16. ↑ Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG et al. (2005) ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 112 (12):e154-235.[1]PMID:16160202

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