What can you do about heart failure?

Heart failure caused by damage to the heart that has developed over time cannot be cured. But it can be managed, often through strategies aimed at improving symptoms.

Treatment success depends on your willingness to become involved in managing the condition. You, your loved ones, and your caregivers all play active roles within the care team.

Your treatment plan may include:

• Lifestyle changes;
• Medications;
• Devices and surgical procedures;
• Ongoing care;

Regardless of your treatment approach, you must follow all of your doctor's recommendations and make necessary changes to your diet, exercise, and lifestyle to give yourself the best possible quality of life. In this article, we will describe surgical options for treating heart failure.

Surgical Treatments for Heart Failure

Heart Transplant

Some people suffer from severe, progressive heart failure that cannot be relieved by medications or dietary and lifestyle changes. In these cases, a heart transplant may be the only effective treatment option.

Surgeons replace the damaged heart with a healthy heart from a donor who has been declared brain dead. It may take several months to find a donor heart that closely matches the recipient's tissues. But this matching process increases the likelihood that the recipient's body will accept the heart.

During a heart transplant, the surgeon connects the patient to a heart-lung machine, which takes over the functions of the heart and lungs. The surgeon then removes the diseased heart and replaces it with the donor heart. Finally, the major blood vessels are connected, and the new heart is ready to function.

The outlook for people who have undergone heart transplantation is good for the first several years following the transplant. In fact, about 90% of patients live more than one year after their operation. However, the number of patients who receive a heart transplant is still relatively small, approximately 2,500 per year.

Percutaneous Coronary Intervention or Angioplasty

Heart failure can develop when blockages in the coronary arteries restrict blood flow to the heart muscle. Removing these blockages can improve overall heart function, which may improve or resolve symptoms of heart failure. Angioplasty is one type of procedure that can reopen blocked blood vessels.

This procedure is typically performed in the cardiac catheterization laboratory. A small tube (catheter) with a tiny deflated balloon on its tip is inserted through an incision in the groin or other area where the artery is accessible and advanced to the diseased artery. Next, the balloon is inflated to open the artery. The balloon is removed once the artery is fully open.

A stent may be placed during the procedure to help keep the blood vessel open. While there is a slight risk of artery damage during angioplasty, this procedure generally improves the patient's condition.

Coronary Artery Bypass Grafting

Coronary artery bypass grafting involves routing the blood supply around a blocked section of artery.

During this procedure, surgeons remove healthy blood vessels from another part of the body, such as a leg or chest wall. They then surgically attach the vessels to the diseased artery so blood can flow around the blocked section.

After a coronary artery bypass graft, it is especially important that you reduce the amount of fat and cholesterol you consume, as these substances cause arteries to become blocked. Doctors also recommend increasing physical activity to strengthen the heart muscle.

Valve Replacement

Heart failure is sometimes caused by a faulty or diseased heart valve.

Heart valves regulate blood flow inside the heart. When the valves don't work properly, it puts extra stress on the heart and can lead to heart failure.

For some valve problems, medical management is the first step of treatment. Surgical correction of the problem often improves or resolves the condition.

Different replacement valves can be used, including a mechanical valve made of metal and plastic, or a valve made from human or animal tissue. During the operation, the patient is connected to a heart-lung machine that provides blood to the brain and body. The failing valve is removed and replaced.

After the operation and depending on the type of replacement heart valve used, patients may take medication to prevent blood clots from forming around the new heart valve. This treatment is often long-term to ensure the proper functioning of the new valve. Most heart valve replacement operations are successful, but the operation is only considered when a faulty or diseased valve threatens a person's life.

In some patients, heart valve replacement can be done without surgery. But candidacy for this type of procedure is highly individualized.

Coping with Advanced Heart Failure

While it can be challenging to live with a chronic illness like heart failure, many people learn to manage symptoms and live full lives.

People who report improved condition and emotional well-being often acquire new habits by eating better, tracking and managing their symptoms, and exercising (as directed by their care team).

However, advanced heart failure means the condition has progressed to the point where traditional therapies and symptom management are no longer working. Of the more than 6 million adults living with heart failure, about 10% have advanced heart failure. Their treatment decisions can become more complex.