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Protecting Your Heart
Exciting New Treatments for Heart FailureAdvances in drugs and other therapies can help you live longer and get more out of lifeFor people with heart failure, every breath can be a struggle. Their activities are limited, they’re in and out of the hospital, and in severe cases they have a high risk for sudden death from irregular heart rhythm.The good news is that treatments constantly are improving for heart failure, sometimes called “congestive heart failure” because of the fluids that can build up when the heart pumps insufficiently. Especially when used early, these new approaches are making a big difference in patients’ lives. SurgeryDramatic new approaches in the operating room offer more options to sicker patients, says cardio-thoracic surgeon Gary Szydlowski, M.D., of Lehigh Valley Hospital and Health Network.“Bypass surgery once was thought too risky for patients with heart failure,” he says. “Thanks to today’s techniques, they have access to bypass and valve repair and replacement.” In one such procedure, mitral annuloplasty, surgeons place a ring around the heart’s mitral valve to make it work properly. Previous damage can cause the heart to dilate. Left ventricular remodeling procedures, such as the Dor procedure, involve removing the part that no longer works, putting a patch on the inside of the heart and shrinking it back to more normal size. Patients with a very sick heart following surgery may benefit from a temporary left ventricular assist device (LVAD) that helps maintain the heart’s pumping action. Mechanical devices“This is a really exciting field,” says cardiologist Bruce Feldman, D.O., of Lehigh Valley Hospital and Health Network. “We’re working on a mechanical heart for people with no other options. While that’s not here yet, we do have other ways to improve people’s lives.”ICDs (implantable cardiac defibrillators) are implanted in the chest to detect dangerous heart rhythms and gently shock the heart back on track. They’re more widely used now to reduce the risk for sudden death in heart attack survivors or those with coronary artery disease. Resynchronization therapy, or biventricular pacing, is a new treatment that stimulates both the left and right ventricles (the lower heart chambers) simultaneously. When both sides pump together, patients can enjoy a better life. MedicationsThe mainstays of medical therapy for heart failure have been ACE (angiotensin converting enzyme) inhibitors, ARBs (angiotensin receptor blockers) and diuretics.Beta blockers have been used for many years to treat heart disease. More recently, researchers have found that these drugs improve both symptoms and surivival rates in people with heart failure. Aldosterone receptor blockers are another class of drugs recently shown to help heart failure patients live longer and stay out of the hospital. Intermittent outpatient IV therapy using a new class of vasodilators (drugs that dilate blood vessels), called natriuretic peptides, is the subject of research studies now under way at Lehigh Valley Hospital for patients with end-stage heart failure. This page last updated 3/30/08 02:54 PM
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