Heart failure

Surgery for heart failure

Most people with heart failure do not need surgery and will be treated with drugs. Heart surgery is only done when doctors think it will improve a problem with the heart valves or the blood supply of the heart, and if the heart is strong enough. In most cases surgery cannot cure heart failure. Surgery that can be used to improve heart failure includes coronary artery bypass graft (CABG), valve replacement surgery and heart transplantation (see also ‘Medical devices for heart failure' and 'heart transplants for heart failure').

Some of those with heart valve problems said that surgery had made a real difference to their quality of life; for instance one woman who had already had 4 heart operations told her surgeon she was still prepared to take the risk of having a fifth operation (the replacement of her mitral valve). She had felt better afterwards. Another woman who had avoided seeing doctors about her heart for many years was given a new mitral valve and said the operation changed her life.

Coronary artery bypass surgery, also known as Coronary Artery Bypass Graft (CABG, pronounced "cabbage") is a type of surgery that improves blood flow to the heart. It diverts blood around narrowed or clogged parts of the major arteries (blood vessels), to improve blood flow and oxygen supply to the heart. A CABG operation involves the use of a piece of a vein from the leg or artery from the chest or wrist. The surgeon attaches this to the coronary artery above and below the narrowed area or blockage. This new blood vessel is known as a graft (for more on CABG see Coronary Artery Bypass Graft Surgery on our Heart Attack website).

People can have CABG surgery following a heart attack, several months later, or following tests results such as an angiogram. Sab avoided a heart attack just because during a consultation for a lung condition he told the consultant about his chest pain. He went on to have a series of tests including an angiogram. It showed that his artery was so bad that it would be dangerous to put a stent in and doctors decided to do a triple bypass instead. One man described how he felt when he was told during his angiogram that he would need bypass surgery immediately.
One woman in her eighties explained how some of the doctors advised against bypass surgery, and why she wanted to go ahead with it. One man reported how the surgeon described the operation to him before he asked him to sign the consent form for bypass surgery. Another man wanted to know how many bypass operations the cardiac surgeon had done before he signed the consent form and what things might go wrong.
Some people felt they wanted to have surgery; for instance a man who had CABG surgery because doctors thought it would prevent sudden death, said that he wanted to feel everything was being done that could be done (for more information see 'Sudden arrhythmic death syndrome' Information sheet from the British Heart Foundation January 2013).
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Sometimes people had expected tests to lead to some kind of surgery and felt slightly disappointed to learn that surgery would not help them. In Brian’s case an angiogram revealed that his heart would no longer be able to cope with surgery. Several described having newer smaller pacemakers fitted which they were pleased about; one man said his doctor had shown him a new and old pacemaker side by side.
When surgery had led to further complications and people had to stay in hospital longer than expected they said their families often felt under strain. Several said that they were disappointed not to recover from bypass surgery as fast as others around them; one man said that he had expected his bypass to make his heart better but was told afterwards that it was more damaged than he had thought.
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CABG surgery usually lasts three-to-six hours. However, some people need more than one bypass and so it may take longer depending on how many blood vessels are being grafted (NHS Choices, April 2012).
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Recovering from surgery could take time. Many people noticed they'd lost weight. Sometimes surgery did not go as well as planned and several people had experienced pain; one man said it had taken 2 years to get the original surgery corrected.

It takes most people several months to recover after the operation. For the first three to six months many people feel very tired, especially at the end of the day. Usually this improves gradually over 12 to 18 months.
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For more on surgery for heart failure see our resources.


 

Last reviewed April 2016.
Last updated April 2016.

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