Inova Heart and Vascular Institute’s advanced heart failure transplant cardiologists and cardiac surgeons work together to help referring physicians manage complex heart failure patients. Our Advanced Heart Failure and Transplant Program provides prognostic testing to assess each patient's status and determine appropriate therapies for consideration.
We provide physician-, nurse- and pharmacist-based optimal medical therapy. We also offer a breadth of investigational medications and devices when conventional medications are not enough. Many innovative solutions, such as remote, home-based monitoring using a pulmonary artery pressure sensor, are utilized to improve care.
Our team also offers advanced surgical interventions, such as mechanical circulatory support with left ventricular assist devices (LVADs), to improve end-stage heart failure patients' quality and quantity of life.
When transplantation is appropriate, your patients benefit from the most experienced heart transplant program in the Washington, DC region. We perform 35-40 heart transplants each year for patients with end-stage heart disease.
Meet our Specialists
When to Consult an Advanced Heart Failure Specialist
Ideally, our team would see patients long before they require advanced therapies or transplant services to establish baseline measures and develop partnerships with the patient's primary care provider and cardiologist.
Patients with any of the following high-risk clinical triggers are an appropriate referral for evaluation by an advanced heart failure and transplant cardiologist:
|I - Inotropes
||Previous or on-going requirement for dobutamine, milrinone, dopamine, or levosimendan
|N – NYHA class/Natriuretic peptides
||Persisting NYHA Class III or IV and/or persistently high BNP or NT-pro-BNP
|E - End-Organ Dysfunction
||Worsening renal or liver dysfunction in the setting of heart
|E - Ejection Fraction
||Very low ejection fraction < 20%
|D – Defibrillator Shocks
||Recurrent appropriate defibrillator shocks
|H - Hospitalizations
||More than 1 hospitalization with heart failure in the last 12 months
|E - Edema/Escalating Diuretics
||Persisting fluid overload and/or increasing diuretic requirements
|L - Low Blood Pressure
||Consistently low BP with systolic < 90 to 100 mm Hg
|P - Prognostic Medication
||Inability to up-titrate (or need to decrease/cease) ACEI, ARBs, ARNIs, B-Blockers or MRAs
sACEI – angiotensin-converting enzyme inhibitor; ARBs – angiotensin receptor blockers; ARNI - angiotensin receptor neprilysin inhibitors; BNP – B type natriuretic peptide; MRAs – mineralocorticoid receptor antagonist
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