Current Treatment Options
In a majority of cases, there is no cure for heart failure. Heart transplantation, replacing the damaged heart with a normal heart from a recently deceased donor, is available to only 2,500 patients per year in the U.S. Therefore, heart failure is most often managed with a combination of therapies, including: medications, life style changes (diet, exercise, etc.), devices and/or surgeries.
Medications and Life Style Changes
A standard medical regimen of beta blockers, diuretics, angiotensin-converting enzymes (ACE inhibitors) and angiotensin II receptor blockers (ARB) are currently recommended in an attempt to improve the pumping function of the heart, thereby improving blood flow to the body and slowing the progression of heart failure. Many patients do well on these medications and are able to control the progression of their disease. However, other patients do not respond to conventional, optimal medical therapy, resulting in a return or progression of heart failure.
Devices and Surgery
There are several interventional and surgical procedures commonly recommended for the treatment of heart failure, including:
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Angioplasty and Stents
Heart failure can be caused by coronary artery disease (blocked arteries in the heart). Angioplasty and stent devices are designed to open blocked arteries. Re-establishing the blood flow to the heart may improve or resolve the symptoms associated with heart failure.
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Pacemakers and Defibrillators
Heart failure can be worsened by irregular heartbeats and result in a poorly functioning heart or even sudden death. Pacemakers and defibrillators can be used (together or separately) to regulate the electrical conduction of the heart and may improve or resolve the symptoms associated with heart failure.
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Coronary Artery Bypass
When coronary artery disease cannot be treated with angioplasty, coronary artery bypass surgery can be performed to re-establish blood flow around the blocked artery and may improve or resolve the symptoms associated with heart failure.
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Heart Valve Surgery
Heart failure can be caused by functional (diseased valve) or structural abnormalities in the heart and result in a malfunctioning valve. Heart valves can be repaired or replaced to re-establish the normal blood flow in the heart and may improve or resolve the symptoms associated with heart failure.
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Partial Circulatory Support Devices
Partial Circulatory Support (PCS) Devices, like the CircuLite Synergy device, are designed to potentially improve or resolve the symptoms associated with heart failure in earlier stage heart failure patients (in NYHA Class IIIb and early Class IV / INTERMACS 4-7) Clinical trials are currently being developed to determine the clinical effectiveness of long-term partial circulatory support in heart failure patients.
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Ventricular Assist Devices
Ventricular Assist Devices (VAD) are surgically placed devices used as a bridge-to-transplant or as destination therapy for the treatment of end-stage heart failure patients. They may improve the symptoms associated with heart failure and may keep patients alive until they can receive a heart transplant. However, these devices represent an emergency, life-saving therapy for patients with advanced heart failure, and require invasive implantation surgery that requires cardiac bypass and sternotomy. These large devices, which are generally reserved for end-stage NYHA Class IV patients, provide full circulatory support, meaning they take over all of the work of the patient's native heart function.
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Heart Transplant
Heart transplants are an option for some end-stage heart failure patients who are not responsive to conventional medical therapy (medications, devices and surgery). Heart transplants are a cure for heart failure. Unfortunately, there is a severely limited number of donor hearts available, and heart failure patients often may have developed other underlying conditions, potentially excluding them from becoming a heart transplant candidate.
