Advanced Heart Failure

Houston Methodist’s heart failure and transplant team includes cardiologists and thoracic surgeons, social workers, psychiatrists, financial analysts, critical care specialists and palliative care coordinators who evaluate, diagnose and treat patients with late-stage heart failure. We look for underlying causes, disease severity and treatment options and tailor our assessments based on each patient’s circumstances.

Our team’s vast experience builds on Houston Methodist’s legacy as a leading U.S. transplant site, performing more than 760 heart transplants since 1968. We dominate the southern United States in heart and multi-organ — kidney/heart, liver/heart and lung/heart — transplants.

In 2015, doctors nationwide referred 350 patients to our experts for assessment because of our skill in evaluating, diagnosing and treating advanced heart failure and other accompanying conditions. As a destination transplant center, Houston Methodist performs heart transplantation on high-risk patients who otherwise would have no options. Generally, our experts perform more than two dozen heart transplantations annually, with 38 heart or multi-organ procedures carried out in 2015.

Houston Methodist’s survival rates following heart transplantation:

  • One year – 89 percent
  • Three years – 80 percent
  • Five years – 75 percent

Houston Methodist also is home to one the largest programs nationwide that implants a specific heart pump in advanced heart failure patients. The pump, a left ventricular assist device (LVAD), can extend the lives of advanced heart failure patients who do not qualify for heart transplantation or assist those who await transplantation.

Our specialists, under the leadership of renowned cardiologist Dr. Michael E. DeBakey, began implanting LVADS in the late 1990s. Since then, we have established a vigorous LVAD treatment and research program, performing an estimated 60 LVAD procedures annually.

We follow more than 130 Houston-area patients at our LVAD clinic. Our experts also lead LVAD research, making Houston Methodist the top-enrolling center in a 41-site worldwide initiative. Additionally, Houston Methodist is a leading center in the Momentum 3 trial, studying differences among ventricular assist systems. Our specialists also participate in international consortiums and conferences to better understand advanced heart failure.

Our commitment to driving advanced heart failure research and treatments extends to educating doctors. In 2014, we were the first of two centers across the country to offer an advanced heart failure fellowship.

Definition
Heart failure generally is considered advanced after conventional treatments stop working, and patients repeatedly are hospitalized. The likelihood of survival significantly decreases to little more than one year.

Symptoms

  • Progressive breathlessness occurring at rest, while eating, taking a shower or talking on the phone
  • Worsening fatigue
  • Reduced blood pressure
  • Progressive inability to tolerate standard medicines

Causes

  • Infiltrative, or restrictive, cardiomyopathy, where the ventricles become rigid and restrict filling
  • Disease-specific cardiomyopathies, where the heart muscle becomes abnormally enlarged, thickened or stiff because of a variety of diseases
  • Cardiac amyloidosis, caused by deposits of an abnormal protein (amyloid) in the heart tissue
  • Hemochromatosis, a genetic condition that causes an iron overload that poisons organs, including the heart
  • Sarcoidosis, the growth of inflammatory cells in different parts of the body, including the heart

Diagnostics

  • Blood tests
  • Catheterization
  • Echocardiography
  • Cardiac MRI
  • Nuclear imaging

Treatments

  • Medicines
  • LVAD, implantation of a device that assists a failing heart, requiring lifestyle changes such as swimming restrictions, showering precautions and taking a blood thinner for life
  • Transplantation
  • Palliative care, providing patients with relief from symptoms, pain and mental and physical stress associated with a serious illness

TREATMENT LOCATIONS

Our physicians at Houston Methodist specialize in managing advanced heart failure at the following convenient locations.