November 11, 2022

Procedures that help with heart failure

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If you’re experiencing the symptoms of heart failure, you may be wondering what treatments exist that could improve your quality of life.

Shortness of breath, fatigue, coughing, swollen legs and ankles: the symptoms of heart failure arise from the fact that the heart muscle is weakened and unable to pump blood through the body the way it should. Heart failure is a chronic, progressive condition that affects 6 million Americans. However, there is hope. Learn about the heart procedures used to treat this condition.

“The term ‘heart failure’ makes it sound like there’s no way out,” said Dr. Kaushik Amancherla, a cardiologist with Vanderbilt Heart and Vascular Institute. “But there are several procedures available to us that can greatly prolong longevity and improve quality of life for our patients.”

“The term ‘heart failure’ makes it sound like there’s no way out. But there are several procedures available to us that can greatly prolong longevity and improve quality of life for our patients.”

Heart procedures that help artery and valve problems

If you have coronary artery disease or heart valve disease, procedures can help improve blood flow. “If we help the heart pump more efficiently,” Amancherla said, “heart failure symptoms can improve.”  

First, your health-care provider may do a cardiac catheterization to help find clogged blood vessels or valve damage. During this procedure, a thin tube (catheter) is inserted into a blood vessel in the leg, arm or neck and is then guided to the heart. A dye is injected and a special type of X-ray called an angiogram is taken of the blood vessels. The following treatments for heart failure can be done to open a blocked artery or fix damaged valves:

  • Angioplasty. This uses a balloon-tipped instrument at the end of the catheter. The balloon is inflated to widen the narrowed artery. In many cases, a stent is inserted to further help the widened artery stay open.
  • Valve repairs or replacements of faulty valves. These procedures, which help blood flow correctly through the chambers of the heart, can also be done during catheterization. Valve repairs or replacements may also be done surgically.

Another option to treat blocked arteries is bypass surgery. This procedure uses a healthy blood vessel from another part of the body (often, from the leg). The healthy blood vessel is attached above and below the blocked area, allowing blood to flow around the blocked artery.

Procedures that help heart rhythm problems

A device may be placed in the chest to help a weak heart maintain a healthy heartbeat so the heart can pump more effectively. In some cases, a wearable device for heart failure may be advised.

  • Pacemaker. This is an implanted device that regulates your heartbeat electronically. It monitors your heart’s rhythm and generates a painless electric impulse that helps the heart beat in a regular rhythm.
  • Biventricular pacing/cardiac resynchronization therapy. This is a type of pacemaker that paces both pumping chambers of the heart at the same time. This helps to coordinate contractions and to improve the heart’s function.
  • Implantable cardioverter defibrillator (ICD). This device is similar to a pacemaker. It senses when the heart is in an abnormal, dangerous rhythm. It then delivers an electrical shock to convert the dangerous rhythm to a normal rhythm. This can be a life-saving device.
  • Wearable cardioverter defibrillator (WCD). This is a vest worn on the chest with a defibrillator built into it. It senses when the heart is beating too fast. It then delivers an electrical shock to convert the fast rhythm to a normal rhythm. “This may be used if you can’t have an ICD or while you’re waiting for an ICD or heart transplant,” Amancherla said. “It may also be used if you’re at high risk for sudden cardiac death.” Usually, a WCD is worn for several weeks or months. In some cases, it may be used longer.

Surgical procedures for severe cases

In more serious cases of heart failure when other treatments no longer work, other surgery options exist, including:

  • Ventricular assist devices (VADs). These are mechanical devices used to take over the pumping function for one or both of the heart’s ventricles. “This may be needed when heart failure progresses to the point that medicines and other treatments no longer help,” Amancherla said. “In some cases, a VAD may be used as a bridge to a heart transplant.” However, not everyone can safely receive this therapy.
  • Heart transplant. This is replacing the diseased heart with a healthy one from a donor. This is an option for a few people who are very sick. A heart transplant is very serious, however, and not everyone can safely undergo this major heart surgery. Your health-care provider can help you determine if this is a path for you.
  • Ultrafiltration. This treatment mechanically removes excess fluid in the body. Ultrafiltration may be an option for people with certain types of heart failure who don’t respond to other treatments, such as fluid-removing (diuretic) medicines.
Man and woman speaking with primary care specialist.

Vanderbilt University Medical Center has one of the top heart failure programs in the nation with the expertise to care for all stages and causes of heart failure, from the most basic to the most complex. Vanderbilt’s innovative treatments offer hope when you need it most.

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