While surgery isn’t often used to treat heart failure, it may be recommended if your condition can’t be helped with medication or dietary and lifestyle changes, or if your doctor believes that’s 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.
“One of the causes of heart failure is ischemia,” said Robert P. Davis, MD, assistant professor of cardiac surgery at Yale School of Medicine in New Haven, Connecticut. “Opening up blood vessels with angioplasty technique or coronary artery bypass surgery is a treatment option for people with heart failure. Sometimes, if you reverse the ischemia, this can relieve their heart failure symptoms.”
Angioplasty
During angioplasty, a catheter with a small balloon-like device is threaded through a vein and opened once it reaches the clogged artery. Then a small wire tube (called a stent) may be placed into the artery to keep it open. There is a slight risk of damage to the artery during this procedure, but angioplasty usually improves the condition.
Coronary Bypass
Meanwhile, coronary bypass surgery requires surgeons to utilize healthy blood vessels from another part of your body, such as a leg or the chest wall, and then attach the vessels to your diseased artery so the blood can flow around the blocked section.
Coronary bypass surgery is one of the most common types of heart surgery that is performed, according to Dr. Davis. Some more serious cases of heart failure may qualify a patient for heart valve replacement or, in extreme cases, a heart transplant.
Valve Replacement
A heart valve replacement is needed when one of your heart valves is diseased or defective, which can lead to extra strain on the heart and ultimately heart failure. A variety of replacement valves can be used, including those made from metal and plastic, as well as those made from human or animal tissue.
The surgery involves the patient being connected to a heart-lung machine while the bad valve is removed or replaced.
Heart Transplant
A heart transplant is for the most dire circumstances. “We refer to this as end-stage heart failure,” said Davis. “We’ve 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 one taken from a donor. Then the major blood vessels are reconnected, and the new heart begins working.
About 90 percent of people live for more than a year after receiving a heart transplant. But it can take several months to find a donor heart that’s a good match. Only around 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 for some people with heart failure:
- Biventricular Pacing Also known as cardiac resynchronization therapy, this pacemaker enables the ventricles to contract more normally and in synchrony.
- Implantable Cardioverter Defibrillator (ICD) This surgically placed device is used in some people who have severe heart failure or serious arrhythmias. The device delivers an electric counter-shock to the heart when a life-threatening abnormal rhythm is detected.
- Left Ventricular Assist Devices (LVADs) These battery-operated, pump-like devices are surgically implanted to help maintain the pumping ability of the heart.
Read the full article here
