Surgical Procedures for Heart Failure

Updated:Sep 9,2014

Surgery isn't frequently used to treat heart failure. However, it's recommended when the doctor can identify a correctable problem that's causing heart failure – such as a defect or a blocked coronary artery. Surgery also may be needed when the heart failure is so severe that it can't be helped with medications or dietary and lifestyle changes. View an illustration of of coronary arteries.

What surgical and other medical procedures might be used?

Percutaneous coronary intervention (PCI) (also referred to as angioplasty)

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

The procedure is usually performed in the cardiac catherization lab. A small tube – a catheter – with a tiny deflated balloon on the end is inserted through an incision in the groin area and pushed through to the diseased artery. Then the balloon is inflated to push open the artery. The balloon is removed once the artery has been fully opened. A stent may be placed during the procedure to keep the blood vessel open. Although there's a slight risk of damage to the artery during this procedure, PCI usually improves the patient's condition.
Watch an animation of PCI.

Coronary artery bypass

Coronary artery bypass surgery reroutes the blood supply around a blocked section of the artery. During this procedure, surgeons remove healthy blood vessels from another part of the body, such as a leg or the chest wall. They then surgically attach the vessels to the diseased artery in such a way that the blood can flow around the blocked section.

After a bypass operation, it's especially important for you to watch your diet and reduce the amount of fat and cholesterol you eat, since these substances cause the arteries to clog. Doctors also recommend following a routine of increased physical activity to strengthen the heart muscles. View an illustration of coronary artery bypass.

Heart transplant

Some people have severe, progressive heart failure that can't be helped by medications and dietary and lifestyle changes. In such cases a heart transplant may be the only effective treatment option.

Surgeons replace the damaged heart with a healthy one taken from a donor who has been declared brain dead. It can take several months to find a donor heart that closely matches the tissues of the person receiving the transplant. But this matching process increases the likelihood that the recipient's body will accept the heart. In some cases surgeons will implant a left ventricular assist device to help the heart function during this waiting period. This mechanical pump helps the left ventricle (lower left chamber) to pump.

During a transplant procedure, 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 reconnected and the new heart is ready to work.

The outlook for people with heart transplants is good during the first few years after the transplant. In fact, over 85 percent of patients live for more than a year after their operations. However, the number of patients who receive heart transplants is still relatively low (around 2,200 each year). Read more about heart transplants.



This content was last reviewed on 08/20/2012.

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