Congestive Heart Failure (cont.)
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Congestive Heart Failure Surgery and Follow-up
Surgery can repair some underlying causes of heart failure, such as blockage of the coronary arteries, a valve problem, a congenital heart defect, or thickened pericardium. For patients with severe coronary artery disease, coronary artery bypass graft (CABG) surgery can be conducted to circumvent blockages in vessels and ensure that the heart muscle maintains its blood supply. Valve replacement surgery can also be performed to repair malfunctioning heart valves. However, once the heart's ability to pump blood is severely, permanently, and irreversibly impaired, no surgery can repair the damage. The only alternative is a heart transplant. This option is for patients who are not elderly and who do not have other medical conditions that would make it unlikely for a heart transplant to be successful. Heart transplant evaluations are done in specialized centers. Over the years there have been new innovations in the field of cardiac surgery and if a heart transplant is not available, a left ventricular assist device (LVAD) may be implanted to help prolong life.
Left ventricle assist device (LVAD): This device is surgically implanted to mechanically bypass the left ventricle. It can be used as a “bridge to transplant” until a heart transplant is available.
Total artificial heart (TAH): For patients with severe, end-stage heart failure.
Congestive Heart Failure Follow-up
If a patient has congestive heart failure, he or she will need frequent, regular medical attention to adjust medications and watch for side effects. Keep scheduled regular visits with the health care provider, as he or she recommends, because congestive heart failure is a serious medical condition that requires constant monitoring. Patients need to educate themselves as much as possible about this life-threatening condition and follow the suggestions below:
Terrence X O'Brien, MD, FACC
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Heart failure is the pathophysiologic state in which the heart, via an abnormality of cardiac function (detectable or not), fails to pump blood at a rate commensurate with the requirements of the metabolizing tissues and/or pumps only from an abnormally elevated diastolic filling pressure.