Common Procedures and Surgeries for Heart Failure Different medical procedures, like coronary artery bypass or percutaneous coronary intervention, can treat the underlying causes of heart failure. Some people may get an implantable device to aid the heart, while others may need a transplant.

Heart failure means your heart no longer supplies the tissues in your body with adequate amounts of blood and oxygen. Depending on the underlying cause, heart function can sometimes improve with medications, lifestyle changes, noninvasive procedures, or surgery.

Surgery for heart failure includes more than one option. The recommended type of surgery depends on the cause and the individual’s needs. For example, valve repair or replacement may restore proper heart function for some people with valve disease, but it may not be an option for others.

The following are the most common procedures when someone has heart failure.

Percutaneous coronary intervention

Percutaneous coronary intervention, formerly called angioplasty with stent, is a minimally invasive procedure that restores blood flow to the heart by unblocking a coronary artery. Coronary arteries supply the heart with oxygen-rich blood.

The term “percutaneous” means through the skin, so it refers to a surgeon reaching your heart or arteries by puncturing the skin rather than cutting an area open.

During a percutaneous coronary intervention, a surgeon inserts a thin, flexible tube (catheter) into an affected blood vessel. They use the catheter to place a mesh stent or balloon that opens the blocked artery and keeps the blood flowing to the heart.

The catheter can be inserted into a blood vessel in your groin and wrist.

An artery blockage is often caused by coronary artery disease resulting from plaque buildup inside your blood vessels. When the plaque ruptures from the artery walls, it may cause a blood clot. A clot may partially or completely block blood flow to the heart.

Coronary artery disease is the most common cause of heart failure. The outcome for people with heart failure who receive this procedure often improves compared to those treated with medications alone. Percutaneous coronary intervention has a small risk of damage to your heart’s blood vessels.

Catheter ablation

A catheter ablation, or radiofrequency ablation, also involves a small and flexible catheter inserted in one of your blood vessels until it reaches your heart. The catheter first explores your heart’s electrical signals to determine the cause of an abnormal heart rhythm (arrhythmia). The doctor then uses radiofrequency energy through the catheter to destroy the tissue causing the problem.

A doctor may recommend catheter ablation if you have an arrhythmia such as atrial fibrillation, which is often associated with a higher risk of heart failure.

A 2023 study found that patients who received medications and underwent catheter ablation to treat end stage heart failure had better outcomes than those treated alone.

Implantable medical devices

A doctor may recommend one of several implantable medical devices depending on the stage of heart failure or arrhythmia. These devices can help your heart pump blood and contract in a proper rhythm. They may include biventricular pacemakers to help the heart chambers beat in a synchronized manner and implantable cardioverter-defibrillators to prevent sudden cardiac death in people with higher risk.

Implantable medical devices can be lifesaving but are generally recommended in particular situations. For example, they may be used in people with life threatening ventricular arrhythmia, which may occur in people at an increased risk of heart failure.

Heart valve repair or replacement

Your heart has four valves that help control blood movement through its chambers. Problems with these valves can lead to increased pressure and heart failure.

Depending on the severity, a heart valve can be repaired or replaced surgically. These surgeries used to be open heart procedures but can now, in many cases, be performed with minimally invasive techniques.

Valve surgeries usually have a high success rate. A 2024 study involving people with valve replacement surgeries reported that, among 132 of them, 96.3% who received bicuspid valve replacement and 97.2% who received a tricuspid valve replacement had survived 4 years later.

Coronary bypass

A coronary bypass involves taking a blood vessel from somewhere in your body and using it to create a new pathway to your heart when a coronary artery is blocked.

The procedure often significantly improves heart failure symptoms and increases the chance of survival. However, lifestyle changes are crucial to recovery, or the new graft can become blocked over time.

Learn more about lifestyle changes to prevent heart disease.

Heart transplant

A heart transplant involves replacing your heart with one from a donor. Transplants are usually reserved for people with heart failure that doesn’t respond to medications and other surgeries.

Candidates for heart transplants are selected under strict criteria because there are only a limited number of donor hearts available.

After a heart transplant, you’ll need to take immunosuppressants to reduce the risk of your body rejecting the new heart.

About half of people who receive a heart transplant have a survival rate of at least 12 to 13 years.

Frequently Asked Questions (FAQs) about Heart Failure Treatment Procedures

What is heart failure?

Heart failure means your heart no longer supplies the tissues in your body with adequate amounts of blood and oxygen. Depending on the underlying cause, heart function can sometimes improve with medications, lifestyle changes, noninvasive procedures, or surgery.

What are the common surgical procedures for heart failure?

Several surgical procedures can treat the underlying causes of heart failure. The recommended type of surgery depends on the cause and the individual’s needs. Here are some common procedures:

1. Percutaneous Coronary Intervention (PCI)

Percutaneous coronary intervention, formerly known as angioplasty with stent, is a minimally invasive procedure that restores blood flow to the heart by unblocking a coronary artery. A surgeon inserts a thin, flexible tube (catheter) into an affected blood vessel to place a mesh stent or balloon that opens the blocked artery.

2. Catheter Ablation

Catheter ablation, or radiofrequency ablation, involves inserting a small, flexible catheter into a blood vessel until it reaches the heart. The catheter explores the heart’s electrical signals to determine the cause of an abnormal heart rhythm (arrhythmia). Radiofrequency energy is then used to destroy the tissue causing the problem.

3. Implantable Medical Devices

Various implantable medical devices such as biventricular pacemakers and implantable cardioverter-defibrillators (ICDs) can help the heart pump blood and maintain a proper rhythm. These devices are recommended depending on the stage of heart failure or arrhythmia.

4. Heart Valve Repair or Replacement

Heart valve repair or replacement involves fixing or replacing the heart’s valves that control blood movement through its chambers. This can often be done using minimally invasive techniques.

5. Coronary Artery Bypass Grafting (CABG)

Coronary artery bypass grafting involves taking a blood vessel from another part of the body and using it to create a new pathway to the heart when a coronary artery is blocked.

6. Heart Transplant

A heart transplant involves replacing the diseased heart with a healthy one from a donor. This procedure is generally reserved for people with heart failure that doesn’t respond to medications and other surgeries.

How effective are these procedures?

Percutaneous Coronary Intervention (PCI)

PCI is effective for people with coronary artery disease, the most common cause of heart failure. It often improves outcomes compared to medication alone but carries a small risk of damage to the heart’s blood vessels.

Catheter Ablation

Catheter ablation is effective for treating arrhythmias such as atrial fibrillation, often associated with a higher risk of heart failure. Patients treated with catheter ablation and medications have better outcomes than those treated with medications alone.

Implantable Medical Devices

Implantable devices are lifesaving and improve heart function in specific situations, such as life-threatening ventricular arrhythmia.

Heart Valve Repair or Replacement

Valve surgeries usually have a high success rate. For instance, a 2024 study found high survival rates among people who underwent bicuspid or tricuspid valve replacements.

Coronary Artery Bypass Grafting (CABG)

CABG significantly improves heart failure symptoms and increases the chance of survival. However, lifestyle changes are crucial to avoid blockages in the new graft.

Heart Transplant

Heart transplants have a high success rate, with about half of recipients having a survival rate of at least 12 to 13 years.

What are the risks associated with these procedures?

Percutaneous Coronary Intervention (PCI)

• Small risk of damage to heart’s blood vessels
• Possible complications from the procedure

Catheter Ablation

• Risk of complications from catheter insertion
• Potential for damage to heart tissue

Implantable Medical Devices

• Risk of infection
• Device malfunction
• Need for periodic checks and potential replacements

Heart Valve Repair or Replacement

• Risk of infection
• Potential for complications from surgery
• Need for lifelong medication in some cases

Coronary Artery Bypass Grafting (CABG)

• Risk of infection
• Complications from surgery
• Possible need for future procedures

Heart Transplant

• Risk of organ rejection
• Need for lifelong immunosuppressants
• Limited availability of donor hearts

What lifestyle changes are recommended after these procedures?

After undergoing any of these procedures, lifestyle changes are crucial for recovery and long-term health. These may include:

• Eating a heart-healthy diet
• Regular exercise
• Quitting smoking
• Managing stress
• Regular follow-ups with your healthcare provider

Takeaway

Many types of surgery and procedures are used to treat heart failure. Surgery may improve heart function depending on the underlying cause of heart failure. Some surgeries may reduce the progression of heart failure, relieve some symptoms, and extend your life. Always consult with your healthcare provider to determine the best treatment plan for your specific condition.