Some patients with congestive heart failure may require surgery and/or the use of specific medical devices to treat the fundamental problem that caused the heart failure. Some treatments that may be considered for those with CHF include:
Coronary Bypass Surgery
If heart failure is the result of or being worsened by blocked arteries in the heart, coronary artery bypass surgery may be needed. Blood vessels taken from the arm, chest, or leg are used to bypass the blocked artery, allowing blood to move through the heart more easily.
Heart Valve Repair
Repairing a damaged valve involves modifying the existing valve to stop the backward flow of blood, repairing it by rejoining valve leaflets or removing extra valve tissue in order for leaflets to close more tightly. In some cases, tightening or even replacing the ring that sits around the valve, known as annuloplasty, is required.
Heart Valve Replacement
A heart valve replacement is required when a faulty valve cannot be repaired. The old valve is replaced with a prosthetic, or artificial one. Some types of modern heart valve repair or replacement can be conducted without open heart surgery, using minimally invasive surgery or cardiac catheterization instead.
ICDs are devices similar to pacemakers that are placed underneath the skin in the chest. Wires lead through the veins within the chest and into the heart. This device monitors heart rhythm, and if the beat becomes dangerous or the heart stops beating, the ICD works to either pace the heartbeat, speed up the heart, or shock the heart back to a normal rhythm.
Cardiac Resynchronization Therapy
CRT involves using a biventricular pacemaker to send timed electrical impulses to the heart’s ventricles, enabling them to pump blood in a more coordinated and efficient way. Often a biventricular pacemaker is used in combination with an ICD.
Ventricular Assist Devices
VADs, or mechanical circulatory support devices, are implantable heart pumps set within the chest or abdomen that help to propel blood from the ventricles, or lower chambers of the heart, to the rest of your body. VADs are often an alternative to heart transplants or used to help those who are waiting for a heart to become available.
Those with severe heart failure who cannot be helped with either medications or surgery may need a donor heart to replace their own. While heart transplants often raise survival rates as well as improving quality of life, candidates for a heart transplant must be placed on a waiting list, often for quite a long time, until an appropriate donor heart becomes available.