Heart failure (sometimes called congestive heart failure or ventricular dysfunction) means your heart muscle is not functioning as well as it should. There are two kinds of heart failure. If the left ventricle (lower left chamber of the heart) is not contracting with enough force it is called systolic heart failure or heart failure with reduced ejection fraction. If the ventricles are stiff and do not relax and fill properly it is called diastolic heart failure or heart failure with preserved ejection fraction. Ejection fraction is the measurement of blood that is pumped out of your heart with each heartbeat. The primary goals of treating patients with heart failure are to decrease the likelihood of disease progression (thereby decreasing the risk of death and the need for hospitalization), to lessen symptoms, and to improve quality of life. A multidisciplinary team of caregivers specializing in heart failure can provide advanced treatment therapies to patients with this condition.
Advanced Heart Failure Team
The George M and Linda H Kaufman Center for Heart Failure is one of the premier facilities in the United States for the care of people with heart failure. The following programs highlight our focus on excellence in patient care:
- The Kaufman Center Heart Failure Intensive Care, J3-2, is a recipient of the Beacon Award of Excellence for continuing improvements in providing the highest quality of care for patients. The Center joins a distinguished group of Gold award recipients for sustaining the highest level of performance in quality standards in patient safety and patient satisfaction.
- Heart failure is the number one reason for hospitalization among patients who receive Medicare benefits. It is also the most common reason patients need to be hospitalized again within 30 days of leaving the hospital after treatment for heart failure. In addition to our Heart Failure Intensive Care unit, J7-2 is a special nursing unit designed for our less critical patients with heart failure. To help reduce the risk of readmission, the staff developed and tested a multi-disciplinary checklist and program used throughout the Heart and Vascular Institute to make sure every patient knows how to manage their heart failure once they go home. The use of this checklist has improved the rates of readmission and patient satisfaction.
- Since 2011, Cleveland Clinic has maintained the American Heart Association's Get With The Guidelines Heart Failure GOLD Plus Certification for improving the quality of care for patients with heart failure. Gold Plus distinction recognizes hospitals for their success in using Get With The Guidelines treatment interventions. This quality improvement program provides tools to guide evidence-based therapies and procedures in managing heart failure across the continuum of disease progression.
The Kaufman Center for Heart Failure Team includes clinicians that specialize in cardiomyopathy and ischemic heart failure. The multidisciplinary team brings together experts in Cardiovascular Medicine, Cardiothoracic Surgery, Radiology, Infectious Disease, Immunology, Pathology, Pharmacy, Bioethics and Social Work with expertise in diagnostic testing, medical and lifestyle management, surgical procedures, and psychosocial support for patients with:
Services Provided for Patients with Heart Failure
Every patient receives personalized testing and treatment to best meet their needs. Cleveland Clinic providers use the most advanced technology and research to ensure the highest level of care.
Diagnostic Capabilities: The Kaufman Center for Heart Failure offers a full range of diagnostic testing for patients with heart failure.
Medical Management of Heart Failure: The Kaufman Center for Heart Failure physicians make sure patients are taking the correct types and amounts of medications needed to prevent the disease from progressing, keep patients out of the hospital, and reduce mortality (death). Our nurses, dietitians and cardiac rehabilitation team counsels patients on diet, exercise and lifestyle changes to help patients participate as much as possible in activities of daily living and to reduce their symptoms.
Electrical Device Management of Heart Failure: Some patients with advanced heart failure may benefit from the use of electrical devices. One type of therapy is cardiac resynchronization therapy (CRT) with biventricular pacemakers. These devices can improve heart function and quality of life. Implantable cardioverter defibrillators (ICDs) may be used to prevent life-threatening heartbeats, to reduce the risk of death.
Surgical Management of Heart Failure: Surgical management involves a wide range of procedures from high-risk conventional cardiac surgeries to heart transplant and mechanical circulatory support (MCS) devices. Advances in minimally invasive, robotically assisted, thorascopic and percutaneous approaches give heart surgeons many options in caring for the high-risk cardiac surgery patient.
Why choose Cleveland Clinic for your care?
Our outcomes speak for themselves. Please review our facts and figures and if you have any questions don’t hesitate to ask.
The Cardiac Transplantation Program at the Kaufman Center for Heart Failure has been performing heart transplants since 1985. Since the program began, staff surgeons have performed more than 1,600 heart transplants. In 2013, 44 cardiac transplants were completed, and 67 patients were implanted with a mechanical circulatory support device. Additionally, staff performed several dual organ transplants including heart/liver, heart/lung and heart/kidney transplants.
Mechanical Circulatory Support (MCS) Devices
The Kaufman Center for Heart Failure has more than 25 years of experience in the use of mechanical circulatory support (MCS) devices. These include ventricular assist devices (VADs) and total artificial heart pumps for support, as a bridge to transplant, and permanent support for patients who are not candidates for organ replacement.
Of all patients who received a heart transplant in 2013, 61.4% were supported on MCS devices at the time of transplant. The emergence of LVAD therapy, in addition to advances in medical therapy has advanced the care of patients with heart failure.
Specialized Programs for Patients with Heart Failure
- Specialized Centers: Members of the Kaufman Center team are part of or work collaboratively with multidisciplinary centers to care for patients with heart failure who have complex medical problems:
- Heart Failure Classes: Group classes for patients with heart failure and their family members are led by a team of nurses, exercise specialists, dietitians, pharmacists and respiratory therapists. The classes provide information about heart failure and tips to successfully manage the condition.
- Heart Care at Home II: This program, part of Cleveland Clinic’s Connected Care Program, provides traditional home healthcare services along with education, care coordination and monitoring to support patients and promote self-care after hospitalization for heart failure.
The Kaufman Center for Heart Failure provides a single location where cardiologists, cardiac surgeons, nurses, nutritionists, cardiac rehabilitation professionals, and clinical and basic research scientists can work together toward the common goal of treating patients with conditions such as cardiomyopathy and ischemic coronary disease and controlling heart failure symptoms, such as shortness of breath, fluid retention, and swelling. The Kaufman Center for Heart Failure is synonymous with patient care, education, research and a healing environment.
Our physicians use the combined resources of the Miller Family Heart & Vascular Institute to accurately diagnose the cause of each patient's heart failure, which allows them to create the best possible treatment plans based on each patient’s own needs. The central idea behind our mission is "excellence through teamwork"
Our Medical Team
Physicians on the staff of the Kaufman Center for Heart Failure have dual appointments in either the Department of Cardiovascular Medicine or the Department of Thoracic and Cardiovascular Surgery as well as in the Multi-Organ Transplant Center. This allows us to make the best possible use of services and creates greater access to research resources.
- Randall Starling, MD, MPH - Medical Director of the Kaufman Center for Heart Failure, Head of the Section of Heart Failure and Cardiac Transplant Medicine, and a Staff Cardiologist in the Robert and Suzanne Tomsich Department of Cardiovascular Medicine
- Nader Moazami, MD - Surgical Director of the Cleveland Clinic Kaufman Center for Heart Failure, Director of the Cardiac Transplantation and Ventricular Assist Device Therapy Program, Staff Surgeon, Department of Thoracic and Cardiovascular Surgery
Tomsich Family Department of Cardiovascular Medicine, Section of Heart Failure
Heart Failure Nurses, Nurse Practitioners, and Physician Assistants
- Kim Bischel-Dunn, RN
- Meredith Lalak, RN
- Joan Clipps, LPN
- Monica Gervais, CNP, CCTC
- Jacqualine Iammarino, CNP
- Alexandria Johnson, CNP, CCTC
- Karen Kiefer, CNP, CCTC
- Dave Pelegrin, RN
- Crystal Kawczynski – Transplant Assistant
Other Department of Cardiovascular Medicine Physician Staff
Section of Electrophysiology and Pacing: Some patients with heart failure can benefit from the use of specialized biventricular pacemakers and ICDs to help control abnormal heart rhythms. We have a team of electrophysiologists who specialize in rhythm disorders and devices that are consulted as needed.
Section of Cardiovascular Imaging: Members of The Miller Family Heart & Vascular Institute’s team of imaging specialists are experts in diagnosing underlying heart conditions that can lead to heart failure.
Department of Thoracic and Cardiovascular Surgery
Nurses, Nurse Practitioners, and Physician Assistants for Transplant and MCS Service
- Tiffany Buda, RN, Clinical Manager
- Kris Ludrosky, RN, CCTC, Assistant Nurse Manager
- Kristin Forbes, ACNP
- Brian Loveland, ACNP
- Kim Miracle, ACNP
- Jennifer Reese, CNP
- Marjorie Urban, ACNP
- Melissa Williams, CNP
- Chad Gady, PA-C
- Sheryl Hostutler, RN
- Susie Raspovic-Hopper, RN
- Michelle Miluk, BSN, RN
- Janna Mutum BSN, RN
- Deanna Hartman, BSN, RN
- Carin Grobolsek, BSN, RN
- Laura Holmes – Transplant Assistant
Other members of the Kaufman Center for Heart Failure team include pharmacists, dietitians, bioethics, nurses, cardiac rehabilitation specialists, radiologists, infectious disease, specialists, and researchers.
What to Expect
Whether you are coming to Cleveland Clinic from around the corner or around the world, we want you to know what to expect before, during and after your visit. If you have any questions while reviewing this information, please contact us. We are happy to answer any questions you may have.
Before Your Appointment
Important information for patients who are coming to see a cardiologist in the Kaufman Center for Heart Failure
If your appointment is scheduled at least one week away, you will be asked to send your records, including medical history, test results and films (such as echocardiogram, cardiac catheterization, chest X-ray, MRI or CT), prior surgery and intervention reports, and device implantation reports. All information should be sent in the same package (clearly marked with your name and address) via Airborne Express, Federal Express, or certified U.S. mail (make sure you have a tracking number) to the physician you will be seeing.
The address is:
Kaufman Center for Heart Failure
9500 Euclid Avenue – Desk J3 - 4
Cleveland, OH 44195
If your appointment is less than a week away, please contact the physician’s office for a fax number to fax records. If you do not have a fax machine, please bring your records and films to your appointment.
Important information for Kaufman Center for Heart Failure Surgical patients
Heart Transplant or LVAD evaluations: Patients who are evaluated for a heart transplant or LVAD evaluation take part in a specialized program that begins at the pre-surgery stage and continues through hospitalization and recovery. Communication occurs through the Heart Transplant office. Please review the complete process on the Heart Transplant Program Website.
Other Heart Surgery: If you would like to be evaluated for other surgical procedures, such as high-risk valve surgery or bypass surgery, please contact the Heart & Vascular Institute Resource Nurses. We will assist you with the process for surgical review.
Traveling to Cleveland Clinic
We would like to make traveling to Cleveland Clinic as easy as possible. If you have any questions, please visit: Information on travel to the Miller Family Heart & Vascular Institute.
During Your Appointment
You will first meet with a physician assistant who will collect your information and begin your evaluation. The diagnosis and treatment of heart failure involves:
1. Thorough history and exam
2. Diagnostic imaging studies
3. Patient management and recommendations
You will then meet with a physician from the Kaufman Center for Heart Failure who will review your records and prior films, take a medical history and perform a physical exam.
Depending on your history and prior testing, you may need to have specialized imaging tests.
Depending on the tests you need, your cardiologist will either meet with you later that day to review the tests with you and determine if you need additional consultations with other Center specialists. Or, your cardiologist will follow up with you by phone.
Your cardiologist will provide you with specific instructions on your plan of care.
How long will you stay at Cleveland Clinic?
To complete all testing, you will need to stay in the Cleveland area 1 to 2 days. It is best to confirm the length of your stay with your cardiologist’s office prior to making travel plans.
After Your Visit
Because symptoms of heart failure vary from patient to patient, your need for follow-up care will be tailored to your needs and discussed with you during your visit.
To make an appointment, please call toll-free 800.659.7822
Let the appointment office know if you are having acute symptoms.
When you make your appointment, ask the appointment secretary for the name of your physician.
For Heart Transplant patient evaluations, please contact the Pre-Transplant office 216.444.8351 or 800.223.2273, ext. 48351
Go to Desk J3 - 4, Sydell and Arnold Miller Family Pavillion, 9500 Euclid Avenue, Cleveland, Ohio.
Use our secure online form to submit an appointment request 24/7. We will receive it and follow-up with you as soon as possible.
Mon. - Fri., 8 a.m. - 5 p.m. (ET)
The Kaufman Center for Heart Failure continues to participate in many clinical research studies. In 2013, the staff participated in more than 20 active protocols. The goals of research are to manage acute heart failure, improve long-term survival, improve patient care and outcomes, minimize postoperative morbidity among patients who have heart transplants, and evaluate the safety and effectiveness of MCS devices.
Personnel from the Kaufman Center for Heart Failure have leadership roles in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). INTERMACS is a national registry for patients with advanced heart failure whose treatment includes MCS device therapy. This registry was created through a joint effort of the National Heart, Lung and Blood Institute (NHLBI), the Centers for Medicare and Medicaid Services (CMS), the Food and Drug Administration (FDA), clinicians, scientists and industry representatives in conjunction with the University of Alabama at Birmingham (UAB) and United Network for Organ Sharing (UNOS).
Scientists in the Kaufman Center for Heart Failure, in collaboration with members of the Lerner Research Institute, study the failing human heart in our research labs.
Total Artificial Heart
The Kaufman Center for Heart Failure medical team, along with Biomedical engineers at Cleveland Clinic, are working to develop a continuous-flow total artificial heart, or CFTAH. Initial results are promising.
Online Disease Management Program
The Online Disease Management Program is an online medical resource authored by heart failure specialists from Cleveland Clinic. When physicians and healthcare professionals follow the most current standards of care and patients are well informed and participate in regular follow-up, the end result is better patient outcomes.
Fellowship and Residency Programs
The Department of Thoracic and Cardiovascular Surgery has a formal postgraduate fellowship training program in cardiac transplantation that began in 1993. The program continues to attract outstanding candidates from a national and international pool who spend a year working exclusively with the transplant and heart failure program.
Section of Heart Failure & Cardiac Transplantation - Department of Cardiovascular Medicine started its advanced fellowship training program in 1995. The curriculum is designed to teach the principles of heart failure and cardiac transplant patient management. After completion of this training program, participants qualify to serve as a Medical Director of a UNOS-certified heart transplant program.
In 2013, the staff of The Kaufman Center for Heart Failure published articles in more than 80 peer-reviewed journals and wrote 21 book chapters.