Advanced Heart Failure & Transplant Program

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

• Angiotensin neprilysin inhibitors (ARNIs) reduce some of the damaging long-term effects of heart failure, such as increased blood pressure and hardening of your arteries
• Angiotensin-converting enzyme (ACE) inhibitors help your heart pump more blood and reduce blood pressure
• Beta blockers reduce blood pressure
• Diuretics help your body eliminate excess fluids and salt that often build up as a result of heart failure

The CDAc provides you immediate care for non-life-threatening symptoms, such as chest pain or shortness of breath. This option allows you to bypass the emergency room and gives you direct access to an attending cardiovascular physician with less wait and expense.

Specialized devices placed inside your body can manage advanced heart failure by regulating your heart beat, pumping blood throughout your body, or even tracking your vital signs to improve your treatment. BIDMC's Advanced Heart Failure Program can treat various heart failure symptoms with a range of devices: 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.

Durable Ventricular Assist Devices are mechanical pumps which are fully surgically implanted in the chest to assist your heart's pumping abilities. They provide improvement in symptoms if you have advanced heart failure that has not responded to medical management. If you receive one of these devices, you will be discharged home with it.

The BIDMC VAD program is a multidisciplinary team of heart failure cardiologists, cardiothoracic surgeons, nurse coordinators, social workers, nutritionists, pharmacists, infectious disease specialists, anesthesiologists, and palliative care specialists who provide world class care for patients with end stage heart failure who require advanced heart failure therapies.

Percutaneous ventricular assist devices are temporary assist devices that are percutaneously placed in the catheterization lab and require inpatient admission. These include impella CP, impella RP, and impella 5.0 devices. These are important treatment options for patients with advanced heart failure and cardiogenic shock awaiting more durable options.

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. This includes minimally invasive mitral valve repair to improve the flow of oxygen-rich blood throughout the body. During this procedure, a device called a MitraClip is implanted through a catheter. This device functions in place of the damaged mitral valve. The procedure helps alleviate the feeling of fatigue or breathlessness that frequently results from a damaged mitral valve.

The Advanced Heart Failure Program provides a dedicated inpatient hospital unit if you require inpatient care. Our unit is staffed by our expert team of cardiologists and cardiac surgeons, along with nurses and nurse practitioners with specialized skills to care for heart failure conditions.

Our Advanced Heart Failure experts conduct full cardiac transplantation evaluations for the most severe cases of heart failure. Our team collaborates with the BILH Heart Transplant Program at BIDMC and manages ongoing treatment after transplant surgery. Learn more about our Heart Transplant Program.