Your heart is an amazing pump in our body. This pump sends the blood needed to every tissue and organ in the body. But sometimes, this heart can become weak. Then the heart is unable to pump as much blood as the body needs. In medical terms, we call this condition Heart Failure (Heart Failure) or (Congestive Heart Failure - CHF). Don't be afraid when you hear this, this does not mean that the heart has stopped working, but that the heart's function has become weak.
In most cases, this condition can be controlled with lifestyle changes and medication. But for some people, these treatments alone are not enough. That's when doctors consider surgery. Surgery can improve your heart's function, reduce symptoms, and help you live longer.
When is surgery necessary?
Now you may be thinking, 'Does everyone have surgery?' No, that's not the case. Your doctor will suggest surgery for several main reasons.
- Treat the underlying condition that caused the heart failure: Sometimes the heart may be weak due to something like heart disease or a valve problem. Surgery can treat that underlying cause.
- Improve heart function: Surgery can make it easier for the heart to pump blood.
- To save life: When the disease becomes too advanced to be controlled with lifestyle changes and medication, surgery may be necessary to save life.
What types of surgeries are performed for heart failure?
There are different types of surgeries for this. Some are minimally invasive surgeries. Others go as far as open-heart surgery and heart transplants. We'll talk about each of these types separately.
| Type of surgery | Simply put... |
|---|---|
| Catheter Ablation | Deactivating areas in the heart that cause abnormal electrical signals. |
| Implanted Devices | Implanting a device such as a pacemaker or defibrillator under the skin to control the heartbeat. |
| Coronary Artery Bypass Graft (CABG) | Creating a new route (bypass) for blood flow, bypassing the blocked blood channel. |
| Angioplasty and Stent | A balloon is used to widen a blocked blood vessel and a small mesh (stent) is inserted to prevent it from becoming blocked again. |
| Heart Valve Surgery | Repairing a malfunctioning heart valve or inserting a new one. |
| LVAD device | Implantation of a small pump (Left Ventricular Assist Device) that helps the heart pump blood. |
| Heart Transplant | Removing the weakened heart and transplanting it with a healthy heart from a donor. |
Catheter Ablation
This is a procedure used to treat an abnormal heart rhythm, called an arrhythmia. This arrhythmia is caused by faulty electrical signals coming from parts of the heart. In this procedure, your doctor inserts a very thin tube (catheter) into your heart through a blood vessel in your groin or arm. Then, using heat or extreme cold through the tube, they destroy the tissue that is sending the faulty signals.
Implanted Devices that Control Heart Rate
If you have a severe arrhythmia, your doctor may decide to implant a small device under your skin. Wires connected to these devices are inserted into your heart. They monitor your heartbeat and send electrical signals when needed to restore your heart rate.
- Implantable Cardioverter Defibrillator (ICD): This detects an abnormal, potentially life-threatening heartbeat and delivers a small electrical shock to the heart to restore it to normal. It's like giving the heart a little 'reset'.
- Permanent Pacemaker: This keeps the heart beating steadily by continuously sending small electrical pulses to the heart.
Coronary artery bypass surgery (Bypass Surgery)
Coronary arteries, which supply blood to the heart, become clogged with fat and cholesterol. This plaque can block the blood vessels. This reduces the amount of blood and oxygen the heart needs. Over time, this weakens the heart muscle. In bypass surgery, the surgeon uses a healthy blood vessel from another part of your body (usually your leg) to create a new route for blood to bypass the blockage.
It's like building a bypass road to avoid traffic jams on a road.
Angioplasty and Stent
This is also a minor surgery to open a blocked coronary artery. In this, a small balloon at the end of a catheter is passed into the blocked blood vessel and inflated. This breaks up the blocked plaque and widens the blood vessel. Then, a small mesh-like tube, called a stent, is placed in the opening to keep it from getting blocked again.
Heart Valve Surgery
The valves in your heart control the flow of blood in one direction. These valves can either not close properly, causing blood to leak backward (regurgitation), or the valve walls can become thick and not open properly (stenosis). In both cases, the heart has to work harder to pump blood. This can also cause heart failure. This surgery involves repairing the malfunctioning valve or replacing it with a new one.
LVAD (Left Ventricular Assist Device)
For some people, heart failure becomes so severe that the heart is unable to pump blood to the body on its own. An LVAD is a small pump that is implanted into the left ventricle of the heart. The controller is worn outside the body. For some people, it is used as a long-term treatment, while for others, it is used as a temporary 'bridge' until a heart transplant is available.
Heart Transplant
This is the last option for someone with end-stage heart failure. Your weakened heart is removed and a healthy heart from a deceased donor is transplanted. However, due to the shortage of donor hearts, you must meet very strict criteria to qualify for a heart transplant.
What happens before and after the surgery?
Your doctor will give you all the necessary instructions before the surgery. For example:
- Things to eat and drink and things not to do
- Medications to take and stop
- What to wear and what to bring when coming to the hospital
After surgery, you will be transferred to the intensive care unit (ICU) or a general ward. The length of time you stay in the hospital will depend on the type of surgery you had and your health. You may be able to go home within a day, or you may need to stay for a few weeks. Some people may also need to stay in a rehabilitation center for a while to regain their strength.
What are the risk situations?
As with any surgery, there are some risks. There is a small chance of bleeding, infection, stroke, and even death. But don't worry. Your surgeon will explain to you clearly how these risks relate to your age and other medical conditions. Ask about any questions or concerns you may have at that time.
When should I see the 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 any of the following symptoms worsen or develop.
| Symptom | Description |
|---|---|
| Fatigue/Weakness | Feeling overly tired even after doing a small task. |
| Difficulty breathing | Shortness of breath when resting, walking, or bending over. |
| Swelling (Edema) | Swelling of the legs, ankles, feet, or abdomen. |
Follow the doctor's instructions exactly after the surgery. Go to the clinics on the scheduled dates. If you have any problems or discomfort during the recovery period, never hesitate to talk to the doctor about it.
Take-Home Message
- Heart failure is a weakening of the heart, not a complete heart failure. This is a condition that can be well controlled with proper treatment.
- Surgery may be a good option when medication and lifestyle changes are not enough.
- There are many different types of surgery, from minimally invasive surgery to heart transplants. Your doctor will decide what is best for you.
- Before surgery, talk openly with your doctor about its benefits and risks.
- Following medical instructions and regular medical supervision are very important for recovery after surgery.
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