CHF - surgery; Congestive heart failure - surgery; Cardiomyopathy - surgery; HF - surgery; Intra-aortic balloon pumps - heart failure; IABP - heart failure; Catheter based assist devices - heart failure
The main treatments for heart failure are making lifestyle changes and taking your medicines. However, there are procedures and surgeries that may help.
A heart pacemaker is a small, battery-operated device that sends a signal to your heart. The signal makes your heart beat at the correct pace.
Pacemakers may be used:
When your heart is weakened, gets too large, and does not pump blood very well, you are at high risk for abnormal heartbeats that can lead to sudden cardiac death.
The most common cause of heart failure is coronary artery disease (CAD), which is a narrowing of the small blood vessels that supply blood and oxygen to the heart. CAD may become worse and make it harder to manage your symptoms.
After performing certain tests, your health care provider may feel that opening a narrowed or blocked blood vessel will improve your heart failure symptoms. Suggested procedures may include:
Blood that flows between the chambers of your heart, or out of your heart into the aorta, must pass through a heart valve. These valves open enough to allow blood to flow through. They then close, keeping blood from flowing backward.
When these valves do not work well (become too leaky or too narrow), blood does not flow correctly through the heart to the body. This problem may cause heart failure or make heart failure worse.
Heart valve surgery may be needed to repair or replace one of the valves.
Some types of surgery are done for severe heart failure when other treatments no longer work. These procedures are often used when a person is waiting for a heart transplant. They are also sometimes used long term in cases when transplant is not planned or possible.
Examples of some of these devices include left ventricular assist devices (LVAD), right ventricular assist devices (RVAD), or a total artificial hearts. They are considered for use if you have severe heart failure that cannot be controlled with medicine or a special pacemaker.
Devices inserted through a catheter such as intra-aortic balloon pumps (IABP) are sometimes used.
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Ewald GA, Milano CA, Rogers JG. Circulatory assist devices in heart failure. In: Felker GM, Mann DL, eds. Heart Failure: A Companion to Braunwald's Heart Disease. 4th ed. Philadelphia, PA: Elsevier, 2020:chap 45.
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Mann DL. Management of heart failure patients with reduced ejection fraction. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 50.
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Rihal CS, Naidu SS; Society for Cardiovascular Angiography and Interventions (SCAI), et al. 2015 SCAI/ACC/HFSA/STS clinical expert consensus statement on the use of percutaneous mechanical circulatory support devices in cardiovascular care: Endorsed by the American Heart Association, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; affirmation of value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d'intervention. J Am Coll Cardiol. 2015;65(19):e7-26. PMID: 25861963 pubmed.ncbi.nlm.nih.gov/25861963/.BACK TO TOP
Review Date: 4/10/2023
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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