In recent years, many new technologies and advances in the surgical treatment of heart failure have emerged. Patients with reduced heart function are no longer off-limits for surgical procedures, and treatments such as coronary artery bypass techniques, valve repair, and replacement surgery are now on the same footing as heart transplantation and have become the first-line surgical treatment for heart failure. Minimally Invasive Aortic Valve Replacement: Surgical Valve Replacement for the Elderly Previously, elderly people with heart failure (mostly older than 80 years old) could only undergo conservative treatment because they were unable to undergo traditional surgical valve replacement. Minimally invasive aortic valve replacement is now being used in the clinic, primarily for those with advanced heart failure, and includes transcatheter and transapical aortic valve replacement. Current results show that this procedure improves cardiac function, with the greatest early benefit especially in those patients with very poor left ventricular function. Some statistics show a 12% reduction in mortality compared to the predicted risk of death at 30 days and an improvement in symptoms of left ventricular insufficiency. Mitral valve repair: the first choice for patients with mitral valve insufficiency Mitral valve insufficiency is a common complication in patients with heart failure and accounts for approximately 59% of patients with moderate to severe mitral valve insufficiency in the progressive phase. Functional mitral valve insufficiency significantly shortens the long-term survival of patients with heart failure, which is estimated to be between 6 and 24 months. Mitral valve repair surgery not only facilitates recovery of valve function but also improves ventricular function. Because the results of this procedure are similar to those of heart transplantation while avoiding immune rejection, this mitral valve repair technique coupled with drug therapy will be the first-line treatment for mitral valve closure insufficiency and dilated cardiomyopathy. Myocardial Resection: Good for Young Patients Most cardiomyopathies progress to heart failure at the end stage after drug therapy, and surgery can now successfully help cardiomyopathy patients return to a normal life without further symptoms. In severe cases of obstructive hypertrophic cardiomyopathy, myocardial resection is a more effective form of treatment. It is indicated for young patients for whom drug therapy is not effective. By removing the thickened portion of the heart septum that extends into the left ventricle, the surgery widens the passage from the left ventricle to the aorta, thereby improving the blood supply to the heart, and the “bad” tissue that is removed does not have the ability to regenerate. If necessary, the surgeon will also take the opportunity to repair or replace the abnormal mitral valve. This procedure is generally successful. Coronary Artery Bypass Surgery: New Advances Make Surgery Safer Coronary artery bypass surgery is no stranger to the surgical treatment of patients with heart failure, and it is the most common procedure used in the surgical treatment of heart failure patients. One study showed that for patients with severe angina combined with three branch lesions, there was a significant difference in 5-year survival rates after drug therapy and surgery, 52% and 82%, respectively. Previously, coronary artery bypass surgery in patients with heart failure was associated with greater risk. Now, with improved myocardial protection measures and advances in imaging technology, surgeons have made further improvements in determining viable myocardium, making treatment safer and patients benefiting more from the procedure.