“I’m sorry, Mr. Smith. Your heart is very sick, and your body has irreversible damage. It’s too dangerous to attempt a transplant or implant a heart pump. There’s nothing more we can do.” I’ve encountered this scenario more often than I care to admit as a cardiac surgeon that treats advanced heart failure. Tragically, many of these patients present long after being followed closely by their referring providers—“I’ve been seeing Mr. ...

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