Advanced Heart Failure

The Center for Advanced Heart Failure & Pulmonary Vascular Disease at Hartford Hospital provides a comprehensive care network for patients with advanced heart failure – both in the inpatient and outpatient settings. The Center is staffed by attendings trained in advanced heart failure and supported by a team of dedicated RNs, APRNs, care navigators, a transplant support team, a VAD support team, social workers, dietitians, and psychologists. Patients with advanced heart failure are followed across the spectrum of their disease – outpatient care includes infusions of intravenous diuretics in the infusion center, management of inotropic support, VADs, and pre-/post-heart transplant. Inpatient care is wide-ranging, including initiation/titration/continuation of inotropic support; mechanical circulatory support with Impella devices, intra-aortic balloon pumps, ECMO; and ultimately transplant evaluation and heart transplant.

Fellows all complete one four-week rotation on the advanced heart failure service during each of the three years of fellowship. Additionally, they participate in the management of these heart failure patients while on the general consult and CICU services. The time on the rotations is split between telemetry floor plus step-down level of care patients and patients requiring intensive care. This time can also be split with outpatient clinic time, for fellows choosing to do so. During the rotation, fellows attend transplant and VAD meetings to discuss ongoing management and progress of these patients.

Dr. Joe Radojevic, chief of Cardiology and director of Advanced Heart Failure, discusses the Hartford HealthCare Heart & Vascular Institute and provides an overview of the advanced heart failure rotation.