Patients with severe, chronic heart failure can be managed by several surgical techniques that lead to cure for some or provide a bridge to heart transplantation for others. Although transplantation is currently the only proved curative therapy for end-stage heart failure, the supply of donor hearts has not kept pace with the demand. Therefore, procedures such as reduction ventriculoplasty, transmyocardial laser revascularization, or dynamic cardiomyoplasty and the use of assist devices or artificial hearts hold promise for helping patients maintain heart function until a cure can be offered.