Heart Failure Treatment
When symptoms of heart failure worsen despite lifestyle
changes and medication, you may be diagnosed with advanced heart failure. About 10 percent of the 5.7 million
Americans living with heart failure have advanced heart failure – stage D
according to the American Heart Association and American College of
Cardiology’s A-to-D staging system. Treatment for advanced heart failure is
more complex, involving the implantation of devices or, when all other
treatments are no longer effective, heart transplantation.
Life-saving and therapeutic,
ventricular assist devices (VADs) are implantable mechanical circulatory
devices that help pump blood from the left ventricle of the heart to the body.
VADs are designed to partially or completely replace the functions of a failing
heart in patients with severe heart failure, either as a bridge to heart transplantation
or as a long-term destination treatment for those who cannot receive a
transplant. Most often, VADs are designed to assist the left ventricle of the
heart (LVAD), but devices may also be used to assist the right ventricle (RVAD)
or both ventricles (BiVAD). VADs significantly ease the burden on the heart and
other organs, providing a higher survival rate and better quality of life.
Despite growing demand, only
approximately 2,200 donor hearts become available each year in the United
States. When a donor heart is unavailable and both cardiac ventricles fail, a
temporary SynCardia Total Artificial Heart is used as a bridge to
transplantation and can eliminate the symptoms and source of end-stage
biventricular failure. As soon as patients are stabilized following surgery,
they are returned to the active transplant list.
When all other treatments for heart
failure have been unsuccessful, physicians may refer a patient for heart
transplant. Advanced heart failure is staged on a four-point scale; as severity
increases, patients enter stage four or end-stage heart failure, making them
eligible for transplantation. Once transplant candidates have undergone a
thorough screening process, they are placed on the national transplant list and
monitored while awaiting a donor heart. If the transplant candidate’s condition
begins to decline, intravenous medications, total artificial heart or ventricle
assist device implantation may be recommended until a donor heart is available.
are leaders in the management and diagnosis of heart failure, especially in the case of more complex disease. With appropriate medical and surgical intervention and healthy lifestyle habits, patients with heart failure can continue to live full and productive lives.
Specialists at the Center for Advanced Heart Failure at the Memorial Hermann Heart & Vascular Institute-Texas Medical Center provide treatment for more complex cases, including medical management, percutaneous interventions and surgery.