Best of heart failure

35 management of non-cardiac organ systems, the prevention and treatment of infectious complications, and the importance of nutrition, early mobilization, and prophylaxis against deep venous thrombosis, gastric ulcers, and cutaneous ulcers. Indeed, recent data suggests that incorporation of a cardiac intensivist into the team approach improves short- and long-term mortality in CS. In addition, laying out the end goal, exit plan, and bail-out strategies is a funda- mental aspect when planning revascularization in HF patients. Moreover, de- fining medical futility is a critical part of the management of these patients. A team-based approach in these complex contexts may facilitate the decision- making process. Conclusion Given the complexity of the patient population in contemporary clinical practice, the decision regarding revascularization in patients with CAD in the setting of LV dysfunction remains challenging. Clinical decision-making in these cases requires interdisciplinary discussion and assessment of the po- tential long-term survival derived from CABG against its higher perioperative risk. In accordance with the available data, we believe that surgical revascu- larization offers improved survival, particularly in those with more extensive multivessel disease and the greatest degree of LV systolic dysfunction and remodeling. These patients, it must be noted, are also at the greatest short- term risk of mortality with CABG. When necessary, PCI is feasible and safe. Data from large randomized clinical trial testing newer generation stents and the use of mechanical circulatory support is needed to further aid these decisions. A heart-team approach including but not limited to a general cardiologist, heart failure specialist, interventional cardiologist, cardiothoracic surgeon, palliative care provider, and critical care specialist is of paramount importance. Indeed, interventional heart failure is an emerging field within cardiology. Trainees become proficient in interventional cardiology, advanced heart failure, and the use of MCS devices. This new breed of cardiologist may narrow the gap between these two important sub-specialties with an increas- ingly overlapping patient population with the goal of improving outcomes. Compliance with Ethical Standards Conflict of Interest The authors declare that they have no conflicts of interest. Human and Animal Rights and Informed Consent This article does not contain any studies with human or animal subjects performed by any of the authors. Publisher ’ s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. 4 Page 10 of 12 Curr Treat Options Cardio Med (2019) 21: 4