Heart failure is the result of the heart's inability to pump blood as effectively as it should to keep your body functioning and healthy.  Your body relies on the pumping motion of the heart to provide the cells with blood that carry nutrients and oxygen. However, when a person has heart failure, their heart is unable to pump enough blood to their cells. This causes exhaustion, dyspnea (shortness of breath), and frequent coughing, as well as rapid and irregular heartbeats in individuals.   

Heart-related diseases are increasing all over the world, and in India alone there are 1.3–4.6 million heart failure patients who seek treatment each year. As a matter of fact, these days, heart failure (HF) is one of the main causes of mortality and disability in India.

Since heart failure has multiple stages, some people are treated with medicine and other management methods if their condition is at an early stage, but for many others, surgery is the best option that can offer full health recovery. Let’s take a look at the surgical solutions for heart failure that can help people get back to a healthy life! 

What is Heart Failure?

Heart failure is when your heart cannot pump enough blood necessary for your body’s functions. The initial line of treatment for heart failure is often medication and lifestyle modifications, and even though these therapies are frequently quite successful, some patients require heart failure surgery. Your heart's function may be completely improved with surgery, and as a result, you can get back to enjoying your normal fulfilling life. 

There are four phases of heart failure named A, B, C, and D and these stages indicate the intensity of your heart failure symptoms and the health of your heart. In stage A, you may be at risk for heart failure even though you don't have any symptoms. In stage B, you do not exhibit heart failure symptoms, but you do have abnormal alterations in the structure or function of your heart. In stage C, heart failure symptoms are present, and ultimately, in stage D, your heart failure symptoms interfere with your day-to-day activities and may necessitate frequent medical care.  

The type of surgery required for you depends on your heart condition and overall health! A qualified doctor will do checkups and tests before determining which surgery option is best for you. 

Types of Heart Failure Surgery 

Surgery is a highly effective heart failure medical procedure that has multiple options, including open heart surgery, heart transplants, and other less invasive techniques. Let's take a look at the most successful surgery options used to treat heart failure patients! Type of surgery required will depends upon the cause of heart failure.

1. Coronary Artery Bypass Graft Surgery

In patients with coronary artery disease plaque deposits fill the arteries that provide blood to the heart muscle, as a result, your coronary arteries may constrict or become totally blocked because of these deposits. Less oxygen and nutrients reach your heart, and blood flow is disrupted, which the weakens heart muscle over time, making it less able to pump blood. 

A surgeon performs coronary artery bypass graft surgery to reroute blood around a constricted or obstructed coronary artery to keep the heart’s functions normal. They will attach a blood vessel (transplant) above and below the affected spot, and depending on your circumstances, surgeons may execute this treatment as minimally invasive surgery or as open heart surgery.

2. Catheter Ablation

Heart failure can have arrhythmias, abnormal heartbeats brought on by erratic electrical impulses, as a symptom or cause. Healthcare professionals can cure arrhythmias with a minimally invasive method called catheter ablation. A small tube known as a catheter is placed into one of your blood arteries during a catheter ablation operation, and by carefully guiding the catheter to your heart, your healthcare professional can precisely apply heat or cold to particular cardiac regions. By doing this, the tissues responsible for the aberrant electrical impulses are isolated, and symptoms are reduced.

3. Implanted Devices for Arrhythmias

You could be given an implanted device if you have an arrhythmia or a history of a potentially fatal incident brought on by an irregular heartbeat. These devices consist of a controller implanted inside you and wires that your healthcare professional inserts into your heart through a vein. To assist in controlling your heart rate, the controller sends charges to your heart. 

The two most common implanted devices are implantable cardioverter defibrillators (AICD) and permanent pacemakers (PPI). An implanted cardioverter defibrillator can identify an irregular heartbeat and give an electric shock to your heart to return it to normal rhythm, and a permanent pacemaker gives your heart constant electric pulses to maintain a steady heartbeat. 

4. Heart Valve Surgery

When you have heart valve disease, your heart valves may leak, letting blood go backwards instead of forward to the heart’s next chamber for circulation. Additionally, valves may constrict and stiffen, and your heart must work harder to pump blood in both situations. Heart failure may result from this increased strain on your heart's pumping chambers. 

A valve can be replaced or repaired during heart valve surgery, which comes in a variety of forms. Catheters are used for some heart valve surgeries, which only involve a little groin incision, while other heart valve operations use minimally invasive procedures that need a smaller chest incision or sometimes an open heart surgery. 

5. Heart transplant

During heart transplant surgery, a donor's heart is used to replace the patient’s heart! For those with end-stage heart failure, it is the final resort, but there are stringent requirements to be eligible for a heart transplant.

Other Treatment Methods for Heart Failure   

Heart failure complications can completely disrupt a patient’s life, and without medical intervention, it is nearly impossible to cure the condition.  However, surgery is not always needed if the heart problems are detected early, and in such cases, other heart failure prevention methods can be used. Apart from these options, sometimes transient methods for the support of hearts are used, like (IABP), Impella, ECMO, and VAD-Venticular Assist Devices.

Lifestyle changes    

Maintaining a healthy lifestyle, which includes quitting smoking, exercising regularly, and eating a balanced diet, can help manage your heart failure symptoms and lower your chance of developing further health complications. An exercise-based cardiac rehabilitation program is often recommended to patients along with lifestyle modification guidelines! 

Medications 

Heart failure and its underlying cause can be treated with certain medications:

Aldosterone blockers	Aldosterone blockers encourage the body to release water and salt by blocking the actions of the hormone aldosterone, and they also aid in preventing cardiac scarring.
Angiotensin  receptor-neprilysin inhibitor (ARNI)	Sacubitril-valsartan therapy relaxes blood vessels and reduces the body's extra fluid to facilitate the pumping action of your heart.  Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are substitutes for ARNIs.
Beta-blockers	Beta-blockers slow down and lessen the force of the heartbeat and they also aid in maintaining a steady heartbeat.
Sodium-glucose transport protein 2 (SGLT2) inhibitors	Diabetes medications known as sodium-glucose transport protein 2 (SGLT2) inhibitors are highly effective for heart failure management.

Final Remarks 

The heart's pumping motion allows the body to provide each cell with nutrients and oxygen through blood, however, when someone has heart failure, this blood-pumping process gets disrupted. When the heart cannot pump blood efficiently, the cells are not given enough oxygen and nutrition to operate at an optimum level, and as a result, the patient’s health falters.  

Although lifestyle changes and medication can help control heart failure symptoms, some patients with advanced stages of heart failure need surgery to recover. If you are suffering from shortness of breath, palpitations, or other heart-related symptoms, get in touch with an expert cardiologist as early as possible to receive proper treatment without delay!

FAQs

1. Is heart transplantation the only solution for severe heart failure?

No, while heart transplantation is an option for end-stage heart failure, other interventions like LVADs and valve surgeries can improve quality of life and manage symptoms.

2. Who is a candidate for heart failure surgery?

Surgical options are typically considered for patients who do not respond well to medications or lifestyle changes and whose heart condition is worsening. A cardiologist will evaluate the suitability.

3. What is an LVAD, and how does it help heart failure patients?

An LVAD (Left Ventricular Assist Device) is a mechanical pump that supports the heart’s function and blood flow in patients with severe heart failure.

4. Are there risks involved with heart failure surgeries?

Yes, as with any surgery, risks include infection, bleeding, and complications with anesthesia. Your doctor will assess and discuss these risks based on your health condition.

5. How long is the recovery period after heart failure surgery?

Recovery can vary depending on the type of surgery, but most patients need 4-12 weeks for significant improvement. Rehabilitation and follow-up care are essential for recovery.

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