About

Surgical Ventricular Restoration (SVR) is a surgical procedure for patients with Congestive Heart Failure (CHF) that restores the enlarged left ventricle (heart chamber) to a more normal size and shape, greatly improving the pumping action of the heart. The surgeon remodels the dilated ventricle using a device sized and shaped like a normal ventricle. This remodeling or ventricular restoration results in improving the heart's pumping ability. When the heart can pump more effectively, many of the symptoms associated with CHF, such as shortness of breath, fatigue, and edema, are improved or relieved.

Heart Failure

What is heart failure?

The heart is a muscle that pumps oxygen-rich blood to all parts of the body. When you have heart failure, the heart is not able to pump as well as it should. Blood and fluid may back up into the lungs (congestive heart failure), and some parts of the body don’t get enough oxygen-rich blood to work normally. These problems lead to the symptoms of heart failure.

What causes heart failure?

Heart failure may result from any or all of the following:

  • Heart valve disease caused by past rheumatic fever or other infections

  • High blood pressure (hypertension)

  • Active infections of the heart valves or heart muscle (for example, endocarditis or myocarditis)

  • Previous heart attack(s) (myocardial infarction). Scar tissue from prior damage may interfere with the heart muscle's ability to pump normally.

  • Coronary artery disease. Narrowing of the arteries that supply blood to the heart muscle.

  • Cardiomyopathy or another primary disease of the heart muscle

  • Congenital heart disease or defects (present at birth)

  • Cardiac arrhythmias (irregular heartbeats)

  • Chronic lung disease and pulmonary embolism

  • Certain medicines

  • Excessive sodium (salt) intake

  • Anemia and excessive blood loss

  • Complications of diabetes

  • Alcohol abuse

  • Certain viral infections

How does heart failure affect the body?

Heart failure interferes with the kidney's normal function of eliminating excess sodium and waste products from the body. In congestive heart failure, the body retains more fluid, resulting in swelling of the ankles and legs. Fluid also collects in the lungs, which can cause shortness of breath. The changing fluid dynamics of the body in heart failure can also affect the kidneys and the liver.

What are the symptoms of heart failure?

These are the most common symptoms of heart failure:

  • Shortness of breath during rest, exercise, or while lying flat

  • Weight gain

  • Visible swelling of the legs and ankles (due to a buildup of fluid), and, occasionally, swelling of the abdomen

  • Fatigue and weakness

  • Loss of appetite, nausea, and abdominal pain

  • Persistent cough that can cause blood-tinged sputum

The severity of the condition and symptoms depends on how much of the heart's pumping capacity has been compromised.

The symptoms of heart failure may look like other conditions or medical problems. Always talk to your healthcare provider for a diagnosis.

How is heart failure diagnosed?

Your doctor will do a complete medical history and physical exam. Other tests may include:

  • Chest X-ray. This test uses electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. This test shows the size and shape of your heart. Fluid in the lungs will also show up on X-ray.

  • Echocardiogram (also called echo). This noninvasive test uses sound waves to evaluate the motion of the heart's chambers and valves. The echo sound waves create an image on the monitor as an ultrasound transducer is passed over the heart. This shows how well the heart pumps. It also shows the thickness of the heart walls, and if the heart is enlarged. It is one of the most useful tests because it shows a great deal of information about the heart's function and helps guide treatment decisions.

  • Electrocardiogram (ECG or EKG). This test records the electrical activity of the heart, shows abnormal rhythms (arrhythmias), and can sometimes detect heart muscle damage.

  • BNP testing. B-type natriuretic peptide (BNP) is a hormone released from the ventricles that occurs with heart failure. BNP levels are useful in the rapid evaluation of heart failure. In general, the higher the BNP levels, the worse the heart failure. BNP is measured from a blood sample.

Treatment for heart failure

The cause of the heart failure will guide the treatment plan. If the heart failure is caused by a valve disorder, then surgery may be done to fix the valve. If the heart failure is caused by a disease, such as anemia, then the underlying disease will be treated. Although there is no cure for heart failure due to damaged heart muscle, many forms of treatment have been used to treat symptoms very effectively.

Treatment of heart failure may include:

  • Controlling risk factors:

    • Quitting smoking

    • Losing weight (if overweight) and increasing moderate exercise

    • Restrict salt and fat from the diet

    • Avoiding alcohol

    • Proper rest

    • Controlling blood sugar if diabetic

    • Controlling blood pressure

    • Limiting fluids

  • Medication, such as:

    • Angiotensin converting enzyme (ACE) inhibitors. This medicine decreases the pressure inside the blood vessels and reduces the resistance against which the heart pumps. These also help remodel the heart which can promote better pumping ability.

    • Angiotensin receptor blockers (ARB). This is an alternative medicine to reduce workload on the heart if you can't tolerate ACE inhibitors. Some people develop a cough and need to discontinue ACE inhibitors.

    • Diuretics. These reduce the amount of fluid in the body and are among the most important medicines in helping control fluid buildup in the body.

    • Vasodilators. These widen (dilate) the blood vessels and reduce workload on the heart.

    • Digitalis. This medicine helps the heart beat stronger with a more regular rhythm. 

    • Antiarrhythmics. These help maintain normal heart rhythm and help prevent sudden cardiac death.

    • Beta-blockers. These reduce the heart's tendency to beat faster and reduce workload by blocking specific receptors on heart cells. They can also promote better pumping over time.

    • Aldosterone blockers. This medicine blocks the effects of the hormone aldosterone which causes sodium and water retention.

  • Biventricular pacing/cardiac resynchronization therapy. A type of pacemaker that paces both pumping chambers of the heart at the same time to coordinate contractions and to improve the heart's function. Some people with heart failure are candidates for this therapy.

  • Implantable cardioverter defibrillator. A device similar to a pacemaker that senses when the heart is beating too fast and delivers an electrical shock to convert the fast rhythm to a normal rhythm. This can be a life saving device.

  • Heart transplant. This is replacing the diseased heart with a healthy one from a donor.

  • Ventricular assist devices (VADs). These are mechanical devices used to take over the pumping function for one or both of the heart's ventricles, or pumping chambers. A VAD may be necessary when heart failure progresses to the point that medicines and other treatments no longer help. 

Cardiothoracic Surgeons

David A. Bull, M.D.

Patient Rating:

4.8

4.8 out of 5

David Bull, MD, is a member of the Thoracic Oncology Program, a joint effort between Huntsman Cancer Institute and the University of Utah Hospitals and Clinics. The program was developed to offer consultation, diagnosis, and treatment for all chest cancers. Bull is a professor in the Department of Surgery, Division of Cardiothoracic Surgery; progra... Read More

Phillip T. Burch, M.D.

Dr. Burch performs repairs for a wide variety of congenital cardaic anomalies. In additon to clinical responsibilities, Dr. Burch has research interests in single ventricle physiology as well as in derangements in normal neonatal metabolism caused by cardiac surgery.... Read More

Specialties:

Cardiothoracic Surgery, Pediatric Cardiothoracic Surgery

Locations:

Primary Children's Hospital (801) 662-5577

Aaron W. Eckhauser, M.D., M.S.C.I

I joined the University of Utah, Division of Pediatric Cardiothoracic Surgery in 2012. I am board certified by the American Board of Surgery and the American Board of Thoracic Surgery. My clinical interests are focused on caring for all patients, from neonates to adults, with congenital heart defects. I have a special interest in pediatric heart... Read More

Specialties:

Cardiac Mechanical Support, Cardiothoracic Surgery, Heart Transplant, Pediatric Cardiothoracic Surgery

Locations:

A location has not yet been added by this physician.

Specialties:

Cardiothoracic Surgery

Locations:

A location has not yet been added by this physician.

Specialties:

Cardiothoracic Surgery

Locations:

A location has not yet been added by this physician.

Specialties:

Cardiothoracic Surgery

Locations:

A location has not yet been added by this physician.

Ganesh S. Kumpati, M.D.

Dr Kumpati performs adult cardiac surgery, thoracic surgery, and vascular surgery. Dr Kumpati has significant experience in both surgical and endovascular management of aortic disease, including endovascular aneurysm repair. Prior to joining the University of Utah in August 2011, Dr Kumpati was in private practice in Milwaukee, Wisconsin, for 5 y... Read More

Specialties:

Cardiothoracic Surgery

Locations:

University Hospital
Cardiovascular Center
(801) 581-5311
Veterans Administration Medical Center (801) 582-1565

Stephen McKellar, M.D., M.Sc.

Dr. McKellar is a native of Salt Lake City and received his Bachelor of Arts from the University of Utah and his Doctor of Medicine from the George Washington University School of Medicine. He completed his General Surgical and Cardiothoracic Surgical training at the Mayo Clinic in Rochester, Minnesota in a combined, integrated training program. ... Read More

Amit N. Patel, M.D.

Patient Rating:

4.9

4.9 out of 5

Amit Patel, MD, MS, is an associate professor in the Division of Cardiothoracic Surgery at the University of Utah School of Medicine and Director of Clinical Regenerative Medicine and Tissue Engineering at the University of Utah. His clinical interests include heart surgery for coronary disease, valve repair and replacement, heart failure, aortic s... Read More

Craig H. Selzman, M.D.

Patient Rating:

4.8

4.8 out of 5

Dr. Craig Selzman is a Professor of Surgery and Chief of the Division of Cardiothoracic Surgery at the University of Utah who specializes in the care of patients requiring heart surgery. He earned his undergraduate degree at Amherst College and medical degree at Baylor College of Medicine. He received his General and Cardiothoracic Surgery training... Read More

Thomas K. Varghese Jr., M.D., M.S.

Thomas Varghese Jr. MD, MS has specialized expertise in the treatment of diseases of the lungs, esophagus, chest wall and mediastinum. He is board certified in both Surgery and Thoracic Surgery. His main clinical focus is in the use of minimally invasive surgery in the management of patients with tumors in the chest. He has integrated a health serv... Read More

Specialties:

Cardiothoracic Surgery, Nurse Practitioner

Locations:

Eccles Primary Children’s Outpatient Services Building (801) 662-1000
University Hospital
Cardiovascular Center
(801) 581-0434

Specialties:

Cardiothoracic Surgery, Physician Assistant

Locations:

A location has not yet been added by this physician.

Specialties:

Cardiothoracic Surgery, Perfusionist

Locations:

A location has not yet been added by this physician.

Specialties:

Cardiothoracic Surgery

Locations:

University Hospital
Cardiovascular Center
(801) 213-2200

Nathan C. Sontum, PA-C, M.H.S.

PA-C for department of CT surgery 2010-Present... Read More

Specialties:

Cardiothoracic Surgery

Locations:

A location has not yet been added by this physician.

Specialties:

Cardiothoracic Surgery

Locations:

A location has not yet been added by this physician.

Scott A. Tatum, PA-C

Scott came to the University almost 9 years ago from private practice. As a trainer and consultant for Endoscopic Vein harvesting, he has effectively introduced and incorporated new technology and procedures into the University healthcare system. As the senior physician assistant in the division of cardiothoracic surgery, Scott has 17 years experie... Read More

Specialties:

Cardiothoracic Surgery, Physician Assistant

Locations:

University Hospital (801) 581-2121

Locations

University Campus
University Hospital
50 N Medical Drive
Salt Lake City, UT 84132
Map
(801) 581-2121
Primary Children's Hospital
100 N Mario Capecchi Dr
Salt Lake City, UT 84132
(801) 662-1000
Veterans Administration Medical Center
500 Foothill Drive
Salt Lake City, UT 84148
(801) 582-1565