ľ¹ÏÖ±²¥

Implantable cardioverter defibrillator (ICD)

Some people who have severe heart failure or serious arrhythmias (abnormal heartbeats) might need an ICD (implantable cardioverter defibrillators). These devices are placed in your chest during surgery. They detect dangerous abnormal heart rhythms. When they do, they give a shock to reset the heart’s rhythm. Some newer pacemakers can also work like ICDs.

ICDs have saved millions of lives, but they are only used in certain cases. Your health care professional will help you decide if an ICD is right for you.

Learn more about implantable devices.

Cardiac Resynchronization Therapy (CRT)

Some people with heart failure have abnormal heartbeats. This can reduce how well the heart’s lower chambers (ventricles) can work. Cardiac resynchronization therapy, also called biventricular pacing, may be needed. In CRT, a special pacemaker makes the ventricles contract at the same time. This helps the lower heart chambers pump and relax together.

CRT can:

• Improve heart function
• Help keep you out of the hospital 
• Help you live longer

Learn more about cardiac resynchronization therapy.

Left ventricular assist device (LVAD)

The left ventricle is the large, muscular chamber of the heart that pumps blood to the body. An LVAD is a mechanical pump-type device. Some people use this device for a long time. Most often, though, it’s used for a short time if surgery or a heart transplant is needed.

Learn more about LVADs.

Surgical procedures for heart failure

Surgery isn’t common for heart failure. But your health care team might suggest it if they identify a fixable problem that’s causing your heart failure. These could include:

• A heart valve defect
• Blocked coronary arteries

Sometimes surgery may also be needed if heart failure is severe and can’t be treated with medications and lifestyle changes.

Heart transplant 

Some people have severe, progressive heart failure that doesn’t get better with usual treatments. For them, a heart transplant might be the only option.

Surgeons replace the damaged heart with a healthy one from a person who donated their organs. It can take months to find a donor heart that is a match. But this matching process is key to prevent rejection.

During a heart transplant, the surgeon uses a heart-lung machine to take over the heart and lung functions. They remove the damaged heart and replace it with the donor heart. Then, they reconnect the major blood vessels, and the new heart is ready to work.

The outlook for people with heart transplants is good. 

• About 91 out of 100 people live for more than a year  
• On average, people live more than 12 years after 

Only about 4,600 heart transplants are done each year.

Read more about heart transplants.

Angioplasty (also called percutaneous coronary  intervention, or (PCI)

Heart failure can happen when blocked coronary arteries limit blood flow to the heart muscle. The blockage must be removed to improve heart function and relieve heart failure symptoms. Angioplasty, or PCI, is a procedure to open blocked blood vessels.

.

PCI usually happens in the cardiac catheterization lab. A small tube with a deflated balloon is inserted through a small cut in the groin or other area. It’s then pushed to the blocked artery. The balloon is inflated to open the artery and removed when the artery is fully open.

A stent, a small metal tube, can also be placed during the procedure to keep the blood vessel open.

There’s a slight risk of damaging the artery during PCI, but this procedure often helps the patient’s condition.

.

Coronary artery bypass

Coronary artery bypass surgery gives blood a new path around a blocked section of the artery.

Surgeons use a healthy blood vessel from another part of the body, such as a leg, wrist or the chest wall. They attach the blood vessel to the blocked artery so blood can flow around the blockage.

After bypass surgery, it’s important to eat less fat and cholesterol because they can clog arteries. You should also increase your physical activity to make your heart stronger.

.

Heart valve replacement or repair

Heart failure can be caused by a faulty or diseased heart valve.

Heart valves control blood flow in the heart. When the valves don’t work as they should, it puts extra strain on the heart. This can lead to heart failure.

For some valve problems, medical treatments are used first. Surgery can also often fix or improve the problem.

During valve repair, the damaged parts are strengthened. During valve replacement, the old valve is removed and replaced with a new one. The valve can be mechanical – made from metal and plastic. Or it can be biological – made from human or animal tissue. During the surgery, a heart-lung machine keeps blood flowing to the brain and body.

After surgery, patients may need to take medication for a long time to prevent blood clots. Most surgeries are a success, but they are done only when a valve threatens someone’s life.

In some cases, heart valve replacement can be done without surgery. TAVR is a less invasive method. In this procedure, a new valve is placed without taking out the old one. However, not everyone is eligible for TAVR.

Read more about heart valve surgery.