Heart Failure Treatment: Your Complete Guide

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Heart Failure Treatment: Your Complete Guide

Although surgery is not often used to treat heart failure, it may be recommended if your condition cannot be improved by medication or diet and lifestyle changes, or if your doctor feels it is the only way to treat your condition. For example, surgery may be recommended if you have a diseased heart valve or a blocked coronary artery.

“Ischemia is one of the causes of heart failure,” said Robert P. Davis, MD, assistant professor of cardiac surgery at the Yale School of Medicine in New Haven, Connecticut. “Opening blood vessels with an angioplasty technique or coronary artery bypass grafting is a treatment option for people with heart failure. Sometimes, if you reverse the ischemia, it can relieve their heart failure symptoms.”

Angioplasty

Angioplasty, also called percutaneous coronary intervention, is a catheter-based procedure that reopens blocked blood vessels.

During angioplasty, a catheter with a small balloon-shaped device is threaded into a vein and opened once it reaches the blocked artery. Then a small metal tube (called a stent) may be placed in the artery to keep it open. There is a slight risk of injury to the artery during this procedure, but angioplasty usually improves the condition.

Coronary bypass surgery

Meanwhile, coronary artery bypass grafting requires surgeons to use healthy blood vessels from another part of your body, such as a leg or chest wall, then attach the vessels to your diseased artery so that blood can flow around the blocked section.

Coronary artery bypass grafting is one of the most common types of heart surgery, according to Dr. Davis. Some more serious cases of heart failure may warrant heart valve replacement or, in extreme cases, a heart transplant.

Valve replacement

A heart valve replacement is necessary when one of your heart valves is diseased or faulty, which can lead to additional strain on the heart and ultimately heart failure. A variety of replacement valves can be used, including those made of metal and plastic, as well as those made from human or animal tissue.

The surgical procedure involves the patient being connected to a heart-lung machine while the faulty valve is removed or replaced.

Heart transplant

A heart transplant is intended for the most serious circumstances. “We call it end-stage heart failure,” Davis said. “We have exhausted all treatment options.”

During a heart transplant, the surgeon connects you to a heart-lung machine, which takes over the functions of the heart and lungs while the damaged heart is replaced with a healthy heart taken from a donor. Then the major blood vessels are reconnected and the new heart begins to function.

About 90 percent of people live more than a year after receiving a heart transplant. But it can take several months to find a compatible donor heart. Only about 4,600 people receive a transplant each year.

Devices and Implants

The following implanted devices may help improve heart function or protect against sudden cardiac arrest in some people with heart failure:

Biventricular P.succeed Also known as cardiac resynchronization therapy, this pacemaker allows the ventricles to contract more normally and synchronously.

Iimplantable Cardiovert Ddefibrillator (ICD) This surgically placed device is used in some people with severe heart failure or serious arrhythmias. The device delivers an electrical countershock to the heart when a life-threatening abnormal rhythm is detected.

Left vetricular Asister Ddevices (LVAD) These battery-operated devices, similar to a pump, are surgically implanted to help maintain the heart’s pumping ability.