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Congestive Heart Failure (cont.)

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.

  • Alternatively, LVADs are also being used as “destination therapy” in patients who are not eligible for a transplant, but only at approved specialized medical centers.

Total artificial heart (TAH): For patients with severe, end-stage heart failure.

  • These devices are most commonly used as a temporary bridge to heart transplantation, but can be used as destination therapy in patients who are not eligible for a transplant and have a high chance of mortality within 30 days.
  • This technique is constantly improving, but is still limited to specialized centers and is considered experimental at this time.

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:

  • Establish a daily routine for taking medication properly and on schedule.
  • Weigh in daily. Every morning, record the weight in a diary, and take it to the health care provider every visit. An accurate bathroom scale is helpful in monitoring weight gain or loss from day to day in order to detect fluid retention.
  • Keep a list of all medications, with the exact name and dose, and know why each one is taken. Bring them to each follow-up visit so the doctors can double check to make sure patients are on the correct medication and dose.
  • Reminder boxes for medications are helpful.
  • Be sure to keep all these medications away from small children who may accidentally swallow them. Many of the drugs prescribed for congestive heart failure are more dangerous in overdose than other medications.
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Read What Your Physician is Reading on Medscape

Heart Failure »

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.

Read More on Medscape Reference »


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