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Redefining advanced heart failure

  • November 28, 2022
  • Number of views: 411
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Today, patients with congestive heart failure have more treatment options than ever before, and traditional advanced therapies have greatly improved over the last decade. Nationally ranked in Cardiology and Heart Surgery by U.S. News & World Report, our advanced heart failure cardiologists at the Washington University and Barnes-Jewish Heart and Vascular Center work with patients’ current cardiologists and primary care physicians to provide them with the best possible outcomes.

Jonathan Moreno, MD, PhD, assistant professor of medicine at the Washington University School of Medicine, says congestive heart failure patients who are referred early to an advanced heart failure specialist often have better outcomes.

Dr. Moreno recommends cardiologists and primary care physicians consider referring their patients if they:

  • Are on continuous IV medications;

  • Have worsening liver or kidney function along with their heart failure;

  • Have worsening ejection fraction;

  • Have been hospitalized more than once (or have visited the ER more than once) in the last 12 months;

  • Experience increasing cardiac shock and are losing weight because of their heart failure;

  • Fall into the New York Heart Association Class III or IV categories;

  • Have edema;

  • Have low blood pressure;

Dr. Moreno refers to the “I Need Help” chart from the American Heart Association, the American College of Cardiology, the Heart Failure Society of America and the European Society of Cardiology to determine when heart failure patients should be referred to the Washington University and Barnes-Jewish Heart and Vascular Center.

Dr. Moreno says once referred to the Heart and Vascular Center, patients meet with one of 10 advanced heart failure cardiologists. From there, patients meet with a social worker, surgeon, dietician, financial specialist and a LVAD/ transplant nurse coordinator. With the largest center in the region, our team of experts offers a complete range of treatments and personalized, multidisciplinary care for thousands of patients each year.

“Decades of experience, early adoption of state-of-the-art surgical techniques and innovative therapies allow our team of advanced heart failure cardiologists and surgeons to treat patients with all types and stages of heart disease. Our patient outcomes exceed national averages for all cardiology and heart procedures and conditions,” Dr. Moreno says. “We encourage early referrals and co-management with a patient’s local cardiologist. As a patient's heart failure progresses, we already have a relationship with the cardiologist and the patient, and we can intervene early. Unfortunately, patients who are referred too late may have other organ failure which mean limited options.”

Advanced therapy choices, including LVAD and heart transplants, have improved over the last decade, Dr. Moreno adds.

"A LVAD's ability to extend life is incredible," he says. "We can literally pull a LVAD off the shelf and it is a nice, durable strategy for a median of seven years. That's a lot when you were given a death sentence."

Heart transplants now have a median life expectancy of 13 years, but they need early referral.

For more information about the Washington University and Barnes-Jewish Heart and Vascular Center, and to refer a patient, please call 314.362.7260.

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