Heart Transplant and Left Ventricular Assist Devices: Treatment for end stage heart failure
The Cleveland Clinic’s VAD Center consists of a multidisciplinary team of cardiologists, surgeons, advanced practice providers, nurses and other providers who specialize in the evaluation and care of patients who require mechanical circulatory support, such as left ventricular assist device (LVAD) therapy.
For more than three decades, surgeons in the George M. and Linda H. Kaufman Center for Heart Failure Treatment and Recovery at Cleveland Clinic have successfully utilized ventricular assist devices (VADs) as a bridge- to-transplant for patients awaiting heart transplantation and as Destination Therapy for patients who are not transplant candidates. Cleveland Clinic has one of the most experienced and highest VAD programs in the United States, implanting around 100 LVAD every year in recent years. It has been an approved site for disease- specific care for ventricular assist devices since 2008.
The Kaufman Center for Heart Failure Treatment and Recovery is approved by the Centers for Medicare and Medicaid Services and the FDA to offer destination therapy.
Patients who come to the Cleveland Clinic to be evaluated for mechanical assist device have access to the full range of treatment measures for advanced heart failure. Once the patient is fully evaluated, he or she may be offered:
When LVAD therapy is the best option for care, we offer devices as bridge to transplant (until a donor heart is available) or as destination therapy.
The Cleveland Clinic has access to FDA- approved ventricular assist devices, as well as new investigational assist devices.
The most common types of LVADs used at Cleveland Clinic are the Heartmate 3 and Heartware.
WE care for patients with complex medical history that have been turned down by other centers, the Cleveland Clinic might still provide options to assist you.
Why choose Cleveland Clinic for your care?
The Cleveland Clinic VAD team is dedicated to making sure that you have access to the best care possible from evaluation to home. Our team works with the patient and family to make sure they know how to take care of their device at home and provide long term follow up.
For patients who come from far away, the Cleveland Clinic care team may be able to arrange “shared care” with cardiologists with LVAD experience. This means you will be seen by the “shared care” site in between visits with the LVAD team at Cleveland Clinic. We will remain just a phone call away.
The George M. and Linda H. Kaufman Center for Heart Failure Treatment and Recovery is one of the premier facilities in the United States for the care of people with advanced heart failure.
To be evaluated for a left ventricular assist device, call the LVAD team at 216.445.3366.
To refer a patient please call the LVAD team at: 216.445.3366.
The phone number listed for either a LVAD evaluation or referral provides immediate access to the LVAD team who will address your needs promptly. We will need information about the patient and will ask for medical records to assist this process.
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.
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:
Your medical exam includes several tests.
Electrocardiogram
X-ray
Bloodwork
Echocardiogram
Metabolic stress test
Heart catheterization
These tests may be ordered by your heart failure cardiologist or by your surgeon. Some of these tests may have been performed before and will only be repeated if they were not recently performed (within the last 6 to 12 months, depending on the type of test).
Other tests will be recommended based on your medical condition and possible need for specialist input.
Once all testing is complete, your case will be reviewed by your medical team then scheduled for presentation to the Advanced Heart Failure Therapeutics Committee for a final decision. Following the presentation, you will be notified of the outcome by either your cardiologist or another member of the MCS team.
How long will you stay at Cleveland Clinic?
To complete all testing, you will need to stay in the Cleveland area 2 to 4 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.
Ongoing Support after LVAD Therapy
Following your LVAD, the MCS team is responsible for ensuring you (and your family/caregiver) have a full understanding of how to care for yourself and your device. Our goal is to return you to an active lifestyle improving your quality of life.
Patients need to be aware of the following:
You will need to demonstrate independence with your device care prior to going home.
You may be required to stay in the Cleveland area after leaving the hospital for 1-2 weeks before returning home if live more than 2 hours away.
Your evaluation may be completed as an outpatient but you may require admission during the evaluation process if indicated.
The Kaufman Center for Heart Failure Treatment and Recovery continues to participate in many clinical research studies. 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. You may be approached to participate in a clinical research study during your evaluation process.
Personnel from the Kaufman Center for Heart Failure Treatment and Recovery 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).
Clinical Translational Research
Scientists in the Kaufman Center for Heart Failure, in collaboration with members of the Lerner Research Institute, study cardiovascular genomics and research directed at the failing human heart in our research labs.
Publications
In 2018, the staff of The Kaufman Center for Heart Failure Treatment and Recovery published 103 peer reviewed articles and numerous book chapters, abstracts and presented at national and international meetings.
