Heart Failure - Treatment
Since heart failure has many possible causes, there is no single remedy. While some patients respond well to medication, many also need an interventional or surgical procedure. In most cases, a combination of therapies is required.
In managing a patient with heart failure, we focus on four areas:
- optimizing cardiac performance with medications
- minimizing or removing behavioral factors that can aggravate heart failure (e.g., smoking, a high salt diet)
- identifying and treating the underlying disease processes (e.g., a faulty heart valve)
- treating the consequences of heart failure (e.g., fluid retention, breathing difficulties)
Many patients with heart failure will benefit from an interventional or surgical procedure of one type or another. Typically, patients are stabilized first with medications and an interventional procedure (e.g., angioplasty or pacemaker implantation), and then treated surgically, if symptoms progress. Certain conditions are best treated surgically early in the course of the disease, when the patient is stronger and the risk of surgery lower. In some cases, surgery should not be delayed, for example, when the underlying cause is a faulty mitral valve. This condition cannot be definitively treated with medication, and to delay surgery is to risk further, and possibly irreversible, damage to the heart muscle.
Minimally Invasive Heart Surgery
Fortunately, heart surgery is much less traumatic than it was only a decade ago. Recent advances have made it possible to repair the heart with minimally invasive procedures, in which the operation is performed without splitting the breast bone. Compared to conventional open-heart surgery, minimally invasive surgery is much less traumatic to the patient. It not only requires smaller incisions, but also leads to fewer blood transfusions, less postoperative pain, and shorter hospital stays, and quicker recoveries.
