Advanced Heart Failure

The Advanced Heart Failure and Transplant program at UK HealthCare offers the most comprehensive and latest treatment options for patients with congestive heart failure. Patients will have access to the latest advances in medical therapy for heart failure, as well as device therapy such as cardiac resynchronization therapy, and surgical options including ventricular assist devices and heart transplantation. 

Our multidisciplinary team consists of cardiologists, cardiothoracic surgeons, pharmacists and nurses working together to determine the appropriate treatment options for each patient.

What is congestive heart failure?

The heart is a pump and its job is to deliver blood to the rest of the body. If it becomes weakened or stiff, blood cannot be moved as easily, and this can result in blood and fluid backing up into the lungs and the legs/feet. Congestive heart failure is a condition in which the heart cannot pump out all of the blood that enters it, leading to an accumulation of blood in the vessels and fluid in the body tissues.

Risk factors for congestive heart failure 

Advancing age

• Male gender
• African-American heritage
• Poorly controlled high blood pressure
• Diabetes
• Family history of congestive heart failure
• History of alcohol abuse

Common signs and symptoms

The most common signs of congestive heart failure are shortness of breath, fatigue, and swollen ankles or legs. Another symptom is weight gain due to the buildup of fluid in the body.   

Causes of heart failure

Heart failure is usually the result of another condition that makes the heart weak or stiff.  Common causes include:

• Coronary artery disease or previous heart attack (myocardial infarction)
• Disease of the heart muscle (cardiomyopathy)
• Heart valve disorder
• Severe high blood pressure (hypertension)

Treatment options

Congestive heart failure is a chronic disease, but it can be managed successfully with medications and lifestyle changes such as weight loss and exercise. Several medications are available that have been shown to improve symptoms and outcomes in heart failure. If heart failure is due to severe high blood pressure (hypertension), proper treatment of this can improve symptoms. In a few instances, heart failure can be cured through surgical methods. For example, if heart failure is due to a leaky or narrowed heart valve, surgical repair or replacement of the valve can fix the problem. If heart failure is due to severe high blood pressure (hypertension), proper treatment of this can improve symptoms. Device therapy such as defibrillators and cardiac resynchronization therapy can help improve symptoms.

Routine medical follow-up is recommended in patients with heart failure. This allows the medical provider to adjust medication as necessary and monitor the patient’s condition. If heart failure worsens to the point that routine daily activities are difficult to perform, advanced treatment options such as heart transplantation or placement of a ventricular assist device may be considered.  

Heart transplant and ventricular assist devices

For patients with heart failure who cannot be successfully treated with medical therapy, heart transplantation should be considered. UK HealthCare has performed more than 200 heart transplants in its history with excellent results. Consideration of heart transplantation requires multidisciplinary consultation with a transplant cardiologist, a cardiothoracic surgeon, a social worker and a transplant coordinator. The University of Kentucky also has an active ventricular assist device (VAD) program. VADs are surgically implanted pumps that can assist the failing heart and allow patients to feel better.

Advanced certification

The Joint Commission, an independent nonprofit organization that accredits and certifies heath care organizations, recently awarded the UK Gill Heart Institute an advanced certification in ventricular assist devices. To earn this distinction, a program must meet The Joint Commission’s exacting requirements.

Sources:
University of Pittsburgh Medical Center website - http://www.upmc.com
University of Michigan Cardiovascular Center website - http://www.med.umich.edu/cvc
Intermountain Healthcare website - http://intermountainhealthcare.org/Pages/home.aspx