Heart Failure, Cardiac Transplant, and Mechanical Circulatory Support
The Heart Failure, Cardiac Transplant and Mechanical Circulatory Support affinity group at Stanford consists of a group of physicians who specialize in a variety of subspecialties of heart failure management and work in an integrated manner with nurses, dietitians, pharmacists, and social workers to provide highly specialized and comprehensive care to patients with heart failure, and offer cardiac transplantation and mechanical circulatory support for those with end-stage disease.
Heart Failure Clinics
The Stanford Center for Inherited Cardiovascular Disease is led by Dr. Euan Ashley and encompasses a diverse group of physicians and genetic counselors who treat patients with genetic myopathies such as hypertrophic cardiomyopathy, arrhythmogenic right ventricular dysplasia, channelopathies and Marfan syndrome. The group has now become the largest hypertrophic cardiomyopathy center west of the Rockies.
The Stanford Amyloid Center is headed by Dr. Ronald Witteles who works in close collaboration with his colleagues in hematology to provide comprehensive evaluation and care for patients with amyloid heart disease. Dr. Witteles also specializes in the treatment of patients with cardiac sarcoidosis and chemotherapy-related cardiomyopathy.
The Stanford Heart Failure clinic provides care to patients with advanced heart failure and evaluates patients for cardiac transplantation and mechanical circulatory support. The multidisciplinary clinic provides longitudinal care and collaborates with colleagues in electrophysiology, the structural heart program, cardiac surgery and the adult congenital heart disease program.
Stanford is also has a Center for Undiagnosed Diseases that is part of the multi-institutional Undiagnosed Disease Network funded through the National Institutes of Health. It is a multi-disciplinary research center focused on diagnosing rare and unknown diseases utilizing whole genome sequencing.
The field of heart transplantation started in the 1960s at Stanford with initial experiments by Norman Shumway and culminated in the first heart transplant in the United States in 1968. In 2018 the program will celebrate the 50th anniversary of this landmark event. In addition to being the first heart transplant center in the United States, it has also made several landmark contributions to the field, including development of the endomyocardial biopsy, the development of a biopsy grading scheme, the introduction of cold preservation, the first heart-lung transplant and the development of intravascular ultrasound to assess for cardiac allograft vasculopathy.
Other major advances in the field of heart transplantation pioneered by clinicians and investigators at Stanford include the recognition of the role of cytomegalovirus infection in the development of chronic rejection, the use of peripheral gene expression testing for non-invasive rejection surveillance, and most recently, the development of a novel cell-free DNA assay for early detection of graft injury.
Stanford remains a leader in the field of heart failure and heart transplantation, and is proud that its trainees hold distinguished leadership positions at transplant centers around the world.
Mechanical Circulatory Support
Stanford has a long history of involvement in the field of mechanical circulatory support, dating to 1984 with the implantation of the Novacor LVAD as a bridge to transplantation. The mechanical circulatory support program has continued to grow under the leadership of the medical director, Dr. Dipanjan Banerjee and in conjunction with the surgical leadership of Drs. Joseph Woo and Will Hiesinger. The program implants 40-50 VADs a year as both bridge to transplantation and destination therapy. The majority of the implants are with the HVAD (Medtronic, US) and HeartMate3 (Abbott, US).
Advanced Heart Failure Transplant Cardiology (AHFTC) Fellowship Program
The Heart Failure Transplant fellowship program was established in 1989, received ACGME accreditation in 2013 and currently accepts three fellows per year.
Fellowship Webpage: http://med.stanford.edu/cvmedicine/education/ahfc.html