Shall we simply talk about heart failure surgery?

Our heart is an amazing machine that pumps blood that provides oxygen and nutrients to every cell and organ in your body. It's like a motor that supplies water to a house. But sometimes this motor called the heart gets a little weak. Then it can't pump enough blood to the body. In medicine, we call this condition Heart Failure , or as some call it, Congestive Heart Failure (CHF) . Hearing this name can be a bit scary, but it's actually not as scary as you might think. Because there are very good treatments for this.

What exactly is Heart Failure?

Simply put, the heart is a powerful pump made of muscle tissue. When this pump becomes weak, it cannot pump blood fast enough or powerful enough to meet the body's needs. Imagine that your water pump is old and weak. It takes longer to pump water into the tank, and it may not even be able to fill it completely. The same thing happens to the heart.

Doctors usually treat this condition with lifestyle changes (such as cutting back on salt and exercising) and medications. Many people get better with these treatments. But for some, these alone are not enough. That's when surgery may be considered. Surgery can improve your heart's function, reduce symptoms, and help you live longer.

In what cases is surgery necessary?

There are several reasons why your doctor may recommend surgery for heart failure.

• Treat the underlying cause of your heart failure: Your heart failure may be caused by a heart valve problem or a blocked blood vessel. When the underlying cause is removed through surgery, your heart will begin to recover.
• Improve the heart's pumping ability: There are some surgeries that directly help the heart. For example, installing a device like a pump that helps the heart.
• Save a life: When the heart becomes too weak to be controlled with medication and other treatments, surgery may be the last option to save a life.

What types of surgeries are performed for Heart Failure?

There are different types of surgeries for this condition. Some are very simple, done through small incisions. Others go as far as open-heart surgery and heart transplants. Let's talk about each one.

Arrhythmia Treatments

ArrhythmiaIt means that the heart beats irregularly due to a small problem in the heart's electrical system. This can be a cause of heart failure, as well as a symptom.

• Catheter Ablation: This is a very minor procedure. Your doctor will insert a very thin tube (catheter) through a vein in your leg or arm into your heart. Then, they will find the exact location in your heart that is causing the irregular electrical signals and turn it off by applying a little heat or extreme cold to that area. After this, your heart will start beating normally again.
• Implanted Devices: There are two types of small machines that are implanted inside the body to control the heart's rhythm. These are like lifeguards who keep an eye on the heart's rhythm.

Surgeries performed on the veins that supply blood to the heart

• Coronary Artery Bypass Graft Surgery (CABG): Over time, fatty deposits (plaque) build up in the small arteries that supply blood to the heart muscle, causing them to become blocked. This can lead to the heart becoming weak and unable to get the oxygen it needs. A bypass surgery is like creating a new path (a bypass) around a blocked artery. The surgeon uses a piece of artery taken from another part of your body (such as your leg or chest) to create a new path for blood to flow around the blocked artery.
• Coronary Angioplasty and Stent: This is also a treatment to open up the blocked artery, but it is simpler than bypass surgery. Here, you will:

1. A small catheter is inserted into a blood vessel in your wrist or groin.

2. The catheter is passed close to the blocked artery in the heart.

3. When a small balloon at the end of the catheter is inflated, the trapped oil is pushed to the sides and the vein opens.

4. Then, a small mesh-like tube (stent) is placed in that vein to keep it from getting blocked again.

Heart Valve Surgery

Heart valves are the door-like parts between the chambers of the heart that allow blood to flow in only one direction and prevent it from flowing back. These valves can have two types of disease. One is when the valve does not close properly and blood leaks backward (regurgitation). The other is when the valve thickens and does not open properly (stenosis). In both cases, the heart has to work harder than usual to pump blood. Over time, this weakens the heart.

These valves can be repaired surgically, or if that is not possible, a new valve can be inserted (replacement) .

Treatment for extremely weak hearts

• Left Ventricular Assist Device (LVAD): Some people's hearts become so weak that they can't pump blood around the body on their own. An LVAD is a small pump that is implanted in the left ventricle (the main part of the heart that pumps blood) to help them. It can be used as a long-term treatment, or it can be used temporarily until a heart transplant is available.
• Heart Transplant: This is the last option for a patient with end-stage heart failure. In this, the patient's weakened heart is removed and a healthy heart from a deceased donor is transplanted. However, due to the shortage of donor hearts, very strict criteria must be met to qualify for this surgery.

What happens before, during and after surgery?

Preparing for surgery is a big deal. Your doctor will explain everything to you.

• Before surgery: You will be given instructions about when to stop eating and drinking, what medications to continue taking and what to stop, and what to bring to the hospital. When you are admitted to the hospital, a nurse will insert a cannula into your arm to give you saline. The area where the surgery will be performed will be shaved and cleaned. You will usually be fully anesthetized (put to sleep) for the surgery.
• During the surgery: What happens varies depending on the type of surgery being performed. Open-heart surgery involves a large incision in the middle of the chest. However, minor surgeries, such as catheterization, involve only a small incision in the arm or leg. Minor surgeries can be completed in as little as an hour or two.
• After surgery:After surgery, you will be transferred to the intensive care unit (ICU) or directly to a ward. The length of time you will stay in the hospital will vary depending on the type of surgery and your health. Some people can go home within a day, while others may need to stay for weeks. Before you go home, your doctor and nursing staff will give you a clear plan about how to take care of yourself at home, how to take your medications, and when you should come back.

What are the risks of surgery?

Like any surgery, heart surgery carries some risks. The main risks are death, stroke, excessive bleeding, and infection. These risks may vary depending on your age and other medical conditions.

What will life be like after the surgery?

Heart Failure is a condition where symptoms gradually worsen over time. It can make it difficult to even perform daily tasks. However, after surgery, many people's symptoms are significantly reduced, and their quality of life and lifespan increase.

How your result will be depends on several factors:

• Your heart function and symptoms before surgery.
• The success of the surgery.
• How well you take care of yourself after surgery and follow the doctor's instructions.

When do you need to see your doctor?

Heart Failure is a long-term condition, so it's important to stay in touch with your doctor. Tell your doctor right away if your symptoms worsen or if you develop new symptoms.

After the surgery, follow the doctor's instructions exactly. Go to the clinics on the scheduled days. If you have any problems or discomfort during the recovery period, don't be afraid to talk to the doctor about it.