Heart failure surgical therapy

Mechanical support therapy has been a significant addition to the armamentarium against refractory heart failure. However, surgically placed pumps are associated with significant morbidity and mortality, most related to the surgical implantation procedure... 

Ischemic heart disease is the leading cause of death in the United States today (American Heart Association, 2001). In 1998, over 450,000 deaths were attributable to ischemic heart disease. This year over 1.1 million citizens will have a new or recurrent myocardial infarction. One of the consequences of non-fatal myocardial infarction is congestive heart failure (CHF), afflicting 22% of men and 46% of women surviving heart attacks over the subsequent five years. Currently, there are over 4.7 million Americans living with CHF, and these patients have a five year mortality of 50%. The mainstay of therapy for ischemic heart disease is revascularization. Nearly 2,000,000 cardiac catheterizations and 553,000 coronary artery bypass surgical procedures are performed annually (American Heart Association, 2001). 

A confluence of scientific, technical, and medical advancements has made genetic therapeutics for cardiovascular disease a promising and exciting field. The molecular mechanisms of major cardiovascular disorders such as atherosclerosis, ischemic heart disease, and myocardial failure have been well characterized. Sophisticated surgical and catheter-based systems that can enable the delivery of therapeutic genes or cells in vivo are in clinical use, and clinical therapeutic end-points for the evaluation of treatment efficacy have been clearly defined. Simultaneously, gene therapy has evolved from a modality restricted to the potential cure of monogenetic diseases to a therapeutic platform that enables cus-... 

---