Heart failure: Approach to Care
Heart failure occurs when the heart is unable to pump enough blood to meet the body’s needs. There may be a number of causes for this serious condition, and treatment depends on the type and stage of the disease. Early diagnosis can help those with heart failure live an active life.
The UF cardiologists and thoracic and cardiovascular surgeons offer the full range of services for heart failure patients, including:
- Medical management
- Pacing and cardioverter-defibrillator device implantation and management
- Access to investigational mechanical support devices and pharmacologic agents
- Complex cardiac surgeries, including ventricular assist devices and heart transplantation
University of Florida surgeons and researchers maintain a keen interest in the evolving field of mechanical circulatory support. As the population continues to age and the prevalence of heart failure continues to increase, this becomes a ubiquitous problem in society. The rate of cardiac transplantation is limited by donor heart availability. To appropriately support those patients that either are not candidates for heart transplantation, or are too ill to endure the waiting period for a donor heart, other alternatives must be available.
At the University of Florida, we have significant interest and experience in the surgical management of heart failure. This can include surgical restoration of the ventricular geometry in order to provide a more efficient pump mechanism. We are also involved in the pioneering work of several devices to reduce the dilation of the failing heart.
When these options fail, or are unlikely to be successful, then mechanical alternatives must be utilized. This usually involves the placement of ventricular assist devices. A ventricular assist device (VAD) is a mechanical pump-type device that’s surgically implanted. It helps augment the pumping of a failing heart. These devices can be used to augment either one, or both ventricles in the failing heart.
This device is sometimes called a “bridge to transplant.” People awaiting a heart transplant often must wait longer than their extreme illness allows before a suitable heart becomes available. During this wait, the patient’s already-weakened heart may deteriorate and become unable to pump enough blood to sustain life. A VAD can help and support the patient and “buy time” until a heart becomes available. VADs are also now approved for use as destination therapy, meaning the person is not a candidate for a transplant, but can use the mechanical device to maintain their heart function.
We currently implant several types of VADs, each with its own specific clinical indication. As this technology continues to evolve, more people will turn to these mechanical support systems as a means of supporting many patients who otherwise would not be able to receive heart transplants.