Collaborative Care at BIDMC

The Advanced Heart Failure Program brings together a multidisciplinary team of cardiologists and cardiac surgeons who work together to provide a full range of diagnostic and therapeutic services for patients living with all stages of heart failure. Our specialized heart failure services include an active and established program in Ventricular Assist Device (VAD) therapy.


Cardiac nurse and patientWhat is Heart Failure?

Heart failure develops when the heart has weakened or become too stiff to pump enough blood to meet the body's needs. It is a chronic condition, meaning that it can be treated and managed. Depending on the level of severity, heart failure treatments might include medications, devices or surgical procedures.

More about heart failure


Our Services

Our multidisciplinary Advanced Heart Failure Program provides a full range of medical and surgical therapies for patients with all stages of heart failure.

  • Comprehensive care begins with careful evaluation and diagnostic tests to confirm diagnosis and assess severity.
  • When procedures or surgeries are indicated, the Advanced Heart Failure Program provides patients with a dedicated inpatient hospital unit, and an active and established team of cardiologists and cardiac surgeons, supported by a designated team of nurses and nurse practitioners.
  • We provide patients with LVAD support and conduct full cardiac transplantation evaluations for the most severe cases of heart failure.  We work jointly with a local medical center when patients require heart transplantation. 
  • We offer heart failure patients a full range of supportive services including palliative care referrals, nutritional consults and social work consults 
  • Additional services also include outpatient intravenous infusion clinic and referrals to outpatient cardiac rehabilitation programs

Diagnostics

Symptoms of heart failure are often non-specific, but shouldn't be ignored. To confirm a diagnosis of heart failure, the Advanced Heart Failure team conducts the following tests:

  • Blood Tests. Tests may look for biomarkers that are released by the heart when it is overburdened.
  • Imaging Tests. Our Cardiovascular Imaging team can conduct any of several non-invasive imaging tests to help determine how well the heart is pumping.

Medical Management

Although heart failure is a chronic, lasting condition, medications can often reduce symptoms and improve patients quality of life. Members of the Advanced Heart Failure team  may prescribe and of the following medications to manage the condition:

  • Angiotensin-converting enzyme (ACE) inhibitors
  • Beta blockers
  • Diuretics

Implantable Devices

When heart failure has grown more severe it may develop abnormal conduction of the heart's electrical system. This can change how efficiently the heart beats and in severe cases can lead to the development of serious arrhythmias (irregular heartbeats.) BIDMC's  high-volume program offers patients a full range of devices to manage advanced heart failure. 

  • Implantable Cardioverter-Defibrillators (ICDs) are implantable devices that detect life-threatening abnormal heart rhythms (arrhythmias) and correct them by delivering a jolt of electricity.
  • Cardiac Resynchronization Therapy (CRT) involves implanting a biventricular pacemaker to send timed electrical impulses to the heart's lower chambers (the ventricles), helping them to pump in a synchronized manner.
  • Left Ventricular Assist Devices (LVAD) and Right Ventricular Assist Devices (RVAD) are mechanical pumps, implanted in the chest or abdomen to temporarily assist the heart's pumping abilities. The pump may take over the function of either or both ventricles of your heart. Our high-volume LVAD program is provided to patients awaiting heart transplants as well as a long-term treatment option
  • Percutaneous ventricular assist devices. These Catheter-based treatments, including Impella and Tandem devices, are important new treatment options in the management of advanced heart failure.
  • Mechanical support/ECMO (Extracorporeal Membrane Oxygenation). This support device is located outside the patient's body to bring in oxygen and remove carbon dioxide from the blood. BIDMC's high-volume ECMO program supports patients with advanced left ventricular heart failure.

Surgical Services

Cardiac surgery can help improve symptoms of heart failure:

  • Coronary artery bypass surgery (CABG), open-heart surgery, which bypasses the blocked artery
  • Heart valve surgery, to repair defective or diseased heart valves

Advanced Heart Failure Program Wins Quality Award

2017 Get with the Guidelines: Heart Failure, Gold Plus award

The CardioVascular Institute at BIDMC has received prestigious recognition for quality in the care of hospitalized patients with heart failure through the American Heart Association's "Get With the Guidelines" program.