Heart Failure and Cardiac
Transplantation
The Heart Failure and Cardiac Transplantation
Program at HUP offers comprehensive, compassionate
care to patients with congestive heart failure
and cardiomyopathy.
Our multidisciplinary team, available 24 hours
a day, includes some of the nation's finest cardiologists,
cardiothoracic and transplant surgeons, as well
as specialists in cardiac imaging, electrophysiology,
cardiac anesthesia, pulmonary medicine, infectious
disease, immunology and rehabilitation medicine,
all dedicated to the management and care of patients
with severe cardiomyopathy. The multidisciplinary
staff at the Transplant Center has performed over
500 heart transplants.
Our specialized cardiac inpatient units include
a cardiac intermediate care unit, a medical cardiology
unit, a cardiothoracic surgical intensive care
unit and an ambulatory procedure unit. The Heart
Failure and Transplant Ambulatory Care Center
at the Hospital of the University of Pennsylvania
provides an integrated environment including physicians
specializing in the care of patients with heart
failure or heart transplants, transplant coordinators
and nurses, social workers and financial counselors.
More than 7,500 patient visits annually are made
to this state-of-the-art facility.
Penn Cardiac Care also offers the most advanced
surgical therapies available for patients with
end-stage heart failure, such as:
- Thoratec HeartMate™, implantable left ventricular
assist device
- Thoratec, portable biventricular assistance
- Mitral valve repair
- ACORN Cardiocor™
- LionHeart™
The Thoratec HeartMate™ is a revolutionary
technology available only at select cardiovascular
centers in the United States. The vented electrical
option allows some status I transplant candidates
to wait for their transplant at home, instead
of in the hospital. Patients with the HeartMate™
have been maintained for up to two years. In the
near future we expect a new totally implantable
ventricular assist device to be available at Penn.
Recently, new girdling devices have been evaluated
to limit or reverse ventricular remodeling. As
the heart's function worsens, it dilates, develops
mitral valve leaks and grows larger. Penn Cardiac
Care is the only hospital in the region currently
participating in a study examining the ACORN Cardiocor,
a fishnet and polyester jacket that is sewn around
the heart. It is anticipated that, if this "jacket"
can prevent the heart from dilating further, patients
will live longer and feel better.
Several new generation devices have entered into
initial Phase I and II studies which offer more
options for permanent replacement. The AbioCor
(TM) total heart is an artificial heart that replaces
the heart of a dying patient when transplant is
not an option. These patients are expected to
live longer and have a better quality of life
than patients with standard medical therapy, when
transplant is not an option.
The LionHeart™ is a new, left ventricular assist
device (LAVD) located completely inside the body.
Therefore, the patient can be disconnected from
the device's energy source for at least part of
the day and infection rates (which are high in
the devices with a driveline that passes through
the skin) are expected to be very low.
One drawback with these devices is that they
are fairly large, so a small woman or a child
would not likely qualify as a recipient. To combat
this problem, a new category of small mechanical
devices is being developed based on an entirely
different concept of pumping blood. The axial-flow
pump is basically a high-speed propeller that
draws the blood out of the heart and propels it
in a "pulse-less" fashion throughout
the body, up to 10 liters a minute. The main advantage
of these pumps is that they are as small as your
thumb and can be implanted in the chest cavity.
Because of the persistent and worsening shortage
of organ donors, Penn Cardiac Care surgeons perform
procedures on patients who years ago would not
have been candidates for surgery. Improvements
in surgery have made mitral valve repair surgery
(which is better tolerated than a mitral valve
replacement) more common for patients who have
severe mitral valve leaks.
To learn more about heart transplant, please
visit the Penn
Transplant Center web site.
Heart Failure: Cardiologists
Susan
Brozena, MD
Lee
Goldberg, MD
Mariell
Jessup, MD
Andrew
Kao, MD
Heart Failure: Cardiothoracic Surgeons
Michael
Acker, MD
Joseph
Gorman, MD
Robert
Gorman, MD
Rohinton
Morris, MD
Alberto
Pochettino, MD
Bruce
Rosengard, MD
Y.
Joseph Woo, MD
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