The Advanced Cardiac Support team at the Swedish Heart & Vascular Institute (SHVI) cares for patients with heart failure (a condition in which the heart can’t pump as well as it should, limiting the amount of blood available to support the body’s functions; also known as congestive heart failure). Together with the Advanced Cardiac Support team, the Structural Heart and Valve Disease and Cardiac Surgery teams provide several therapies that support these patients. Some therapies may be available only through a clinical research trial. Your doctor will talk with you about the options that are available for your particular situation.
In the simplest terms, heart failure occurs when the heart can’t pump enough blood to meet the demands of the body. Heart failure can be due to:
Therapies for Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy (heart muscle stiffness) occurs when the heart muscle enlarges and outer walls of the ventricles (the lower left and right chambers of the heart) or the wall dividing the heart’s chambers (the septum) thicken and get stiff. Even though the inside of the ventricle may remain the same size, the thickening affects how well they can push blood out of the heart. Hypertrophic cardiomyopathy can also affect the mitral valve (the valve located between the left atrium/upper left chamber and the left ventricle/lower left chamber) of the heart.
Hypertrophic cardiomyopathy is a very common condition in men and women of all ages. It is the leading cause of sudden cardiac death in young adults, including athletes.
The Structural Heart and Valve Disease team offers two therapy options for patients with hypertrophic cardiomyopathy: septal ablation and myomectomy. Your heart team, including a cardiologist and a heart surgeon, will talk with you about your options and determine the best treatment for your specific condition.
Septal ablation is minimally invasive procedure that does not require general anesthesia or a large incision. During a septal ablation, a small amount of alcohol is delivered through a catheter to the septum, which causes the wall to shrink over time to a more normal size. This procedure can improve a patient’s symptoms. The procedure takes about one to two hours. Patients who have a septal ablation typically stay in the hospital two to three days after their procedure.
A myomectomy (also known as myectomy) is an open-heart surgery that requires general anesthesia (the use of special medicines to control pain; general anesthesia puts a patient to sleep). Sometimes myomectomy may be performed at the same time as other surgical procedures. During the surgery, the heart surgeon removes a portion of the septum to make it thinner. The procedure lasts about three to four hours. Typically patients will remain in the hospital several days after the surgery. Older, frail patients with multiple medical conditions are not good candidates for myomectomy.
For more information about myomectomy, go to Swedish Cardiac Surgery >
Therapy for Diastolic Heart Failure
The heart muscle contracts to squeeze oxygen-rich blood from the left ventricle into the aorta (the main artery in the body that delivers oxygen-rich blood) and relaxes to bring more blood into the now-empty ventricle. If the heart muscle is too stiff or thick to relax properly, fluid backs up into the left atrium and the lungs, rather than filling the ventricle. Eventually, this condition leads to diastolic heart failure (a type of heart failure in which the left ventricle can’t relax and fill with blood because it is too stiff; also known as diastolic dysfunction).
The Structural Heart and Valve Disease team is participating in a clinical research trial for a catheter-based procedure (medical procedures that use a catheter to deliver instruments and devices that are used to correct a medical condition) to implant a shunt device to correct this condition. During the procedure, the cardiologist makes a small incision in the groin and threads a catheter (a small, flexible tube) through a vein to the heart. He or she then uses the catheter to deliver the shunt device and implant it in the wall (septum) between the left atrium and the left ventricle. The device creates a small hole, which allows blood to flow more freely between the two chambers.
There are strict eligibility requirements for clinical research trials. Your doctor will discuss this therapy with you if you meet the eligibility requirements for this trial.