ABSTRACT
Congestive heart failure afflicts 2.3% of the U.S. population: 4.9 million people have the
condition and 550,000 new cases are added every year. Its estimated cost for 2005 is 27.9
billion US dollars (1). Congestive heart failure has multiple etiologies but ischemic
cardiomyopathy from coronary artery disease accounts for 75% of the patients. Twenty to
twenty-five percent of heart failure patients have Class III or IV symptoms and 5%–10%
have refractory symptoms. While over 80,000 patients have end stage heart disease, only
2000 transplants were performed in 1999 (2). Patients with advanced ischemic heart disease
and heart failure may not be ideal candidates for heart transplantation since they are usually
over 65 yr of age and have multiple co-morbidities that may exclude them. It becomes
essential therefore to find other treatment modalities for advanced ischemic heart disease.
Surgical revascularization is one of various options available to patients with advanced
coronary artery disease. Surgical revascularization is a well-studied and recommended
option for coronary disease but its role in patients with advanced heart disease is less
well defined.
