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Cardiomyoplasty
This is a procedure wherein the latissimus dorsi muscle is wrapped around the heart and stimulated to contract synchronously with it. It has been largely given up.
Ventricular Reduction Surgery
A large part of the anterolateral wall is resected to make the heart function more efficiently. Both approaches are too risky in end-stage patients and have not been shown to improve prognosis or symptoms in controlled studies, and for these reasons they have largely been dropped.
Ventricular Assist Devices
Externally powered and implantable ventricular assist devices are used in patients who require ventricular support either to allow the heart to recover or as a bridge to transplantation. However, complications are frequent, including bleeding, thromboembolism, and infection, and the cost is very high. Even though 1-year survival has shown improvement in a recent trial, all the patients died by 26 months.
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