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Inotropic agents are often used to reduce congestion and increase cardiac output, while renal replacement therapy may be beneficial if necessary. Cardiac resynchronization therapy has clear benefits in patients with HF with reduced ejection fraction, particularly with left bundle branch block (QRS duration &gt; 130 ms). The role of implantable cardioverter-defibrillators in advanced HF patients requires further investigation considering the introduction of novel HF medications. In selected patients with significant secondary mitral regurgitation, transcatheter edge-to-edge repair can help delay heart transplantation or long-term MCS. In later stages, the appropriateness of heart transplantation should be evaluated, and the use of short- or long-term MCS may be considered. A multidisciplinary HF management program is crucial for patients with advanced HF. Recent treatment advances, including drugs, devices, and MCS, have broadened the options available to patients with advanced HF and this trend is expected to continue.<\/jats:p>","DOI":"10.3904\/kjim.2023.159","type":"journal-article","created":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T20:51:02Z","timestamp":1687899062000},"page":"471-483","update-policy":"https:\/\/doi.org\/10.3904\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Advanced heart failure: a contemporary approach"],"prefix":"10.3904","volume":"38","author":[{"given":"Kyeong-Hyeon","family":"Chun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9856-9227","authenticated-orcid":true,"given":"Seok-Min","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2270","reference":[{"key":"ref1","first-page":"e67","volume-title":"Heart disease and stroke statistics-2018 update: a report from the American Heart Association","author":"Benjamin","year":"2018"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hfc.2015.07.009"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.36628\/ijhf.2021.0023"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2023.0046"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.106.666818"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2016.05.001"},{"key":"ref7","first-page":"e28","volume-title":"Heart disease and stroke statistics--2014 update: a report from the American Heart Association","author":"Go","year":"2014"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.5.628"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1236"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.15829\/1560-4071-2023-5168"},{"key":"ref11","first-page":"e876","volume-title":"2022 AHA\/ACC\/HFSA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology\/American Heart Association Joint Committee on clinical practice guidelines","author":"Heidenreich","year":"2022"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2015.04.013"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2009.02.015"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000525"},{"key":"ref15","first-page":"763","volume-title":"Preoperative INTERMACS profiles determine postoperative outcomes in critically ill patients undergoing emergency heart transplantation: analysis of the Spanish National Heart Transplant Registry","author":"Barge-Caballero","year":"2013"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2019.02.004"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2019.08.017"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.36628\/ijhf.2023.0011"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy600"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1557"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0b013e3181ffe0eb"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.04.051"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa0907118"},{"key":"ref24","first-page":"516","volume-title":"Milrinone as compared with dobutamine in the treatment of cardiogenic shock","author":"Mathew","year":"2021"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.25011\/cim.v42i2.32813"},{"key":"ref26","first-page":"304","volume-title":"Levosimendan vs. dobutamine: outcomes for acute heart failure patients on beta-blockers in SURVIVE","author":"Mebazaa","year":"2009"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2015.08.188"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12177"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1054\/jcaf.2003.24"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.36628\/ijhf.2020.0050"},{"key":"ref31","first-page":"137","volume-title":"The use of diuretics in heart failure with congestion - 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