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Surgical Treatment for HEART FAILURE

Currently, there are many new developments for surgical treatment of heart failure. The method chosen depends on any of the aforementioned causes.

For patients with coronary insufficiency who suffer only moderate myocardial damage, the world standard treatment is revascularization to bring back the blood supply and revitalize the heart muscles.

     In cases with substantial myocardial damage beyond the limit of revitalization, (accurately evaluated non-invasively by echocardiogram or cardiovascular magnetic resonance imaging, the findings revealing that the malfunctioned part of the heart muscle is thin and flaccid resulting in dilatation) surgical removal of the thin portion can efficiently improve cardiac function.

     Even in cases of myocardial damage, not to the extent of dilation, surgical removal of this damaged portion would reduce the size of the heart chamber, and decrease the tension in the remaining part, thereby improving its function.

 

     Another novel modality of treatment is by injecting stem cells (the most early stage of body cells, from which all types of tissue cells derive) into the malfunctioning heart muscles with the assumption that they might induce neovascularization, (formation of new small blood vessels) or even transform themselves into heart muscle cells. If this can be achieved, it would efficiently restore the cardiac function.

In the very severe or final stage of heart failure which resists all forms of medical treatment, a mechanical heart (HeartMate, Norvacor, Micromed DeBakery) taking the place of the heart, has to be used to propel the circulatory system.

The last treatment modality is heart transplantation which can provide a one year survival rate in 90% of cases, and a seven years survival rate in 75% of cases. This measure is limited by scarcity of heart donors, (patients who are brain-dead, but their hearts still suitable for heart transplantation).

Another wishful measure for treating heart failure is to use a totally artificial heart.