Welcome to the Advanced Heart Failure Clinic at the TriStar Centennial Heart and Vascular Center. As part of the TriStar Centennial Heart and Vascular Center, the Advanced Heart Failure Clinic offers a comprehensive disease management program, customized patient education and individual approach to managing heart failure.
About the Advanced Heart Failure Clinic
Our team of cardiologists in Nashville, Tennessee provides our patients with acute, inpatient heart failure care through our certified heart failure specialists. The TriStar Centennial cardiology department is capable of administering guideline-directed medical therapies—drug therapies/medications with proven benefit in the heart failure population based on randomized clinical trials—as well as other advanced therapies and clinical trials.
Our facility offers care coordination, deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient's care to achieve safer and more effective care. TriStar Centennial’s Advanced Heart Failure Clinic offers same-day appointments Monday—Friday, 8:00am—5:00pm and 24/7 patient support services for access to a medical team after standard business hours to address emergencies.
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Heart failure (HF) is a chronic, progressive condition that develops when the heart muscle weakens and is unable to pump a sufficient amount of blood throughout the body. More than 650,000 Americans are living with heart failure disease. Heart failure is a frequent cause for hospitalization. Heart failure worsens over time and is typically caused by persistent high blood pressure, heart attack, valve disease and other forms of heart disease or birth defects. Left untreated, the lack of adequate blood flow causes the organs to fail, resulting in numerous medical complications that deteriorate a person's quality of life, but we are here to help.
What are the signs and symptoms of heart failure?
- Shortness of breath, especially when lying down
- Coughing and wheezing
- Swelling in the feet, ankles and legs
- Weight gain from fluid buildup
Mechanical circulatory support program at Centennial
The Advanced Heart Failure Clinic at TriStar Centennial Heart and Vascular Center will evaluate patients with end stage heart failure for left ventricular assist devices (LVADs) and cardiac transplantation. The mechanical circulatory support program has a multidisciplinary team of board-certified HF specialists, cardiovascular surgeons, advanced practice providers and program coordinators dedicated to helping patients with advanced cardiovascular disease.
A left ventricular assist device is a mechanical device that circulates blood through the body when the heart is too weak to pump blood adequately on its own. It is designed to supplement the pumping function of the heart. The type of LVAD used at TriStar Centennial Heart and Vascular Center is a continuous flow, implantable pump. The LVAD is surgically implanted inside the chest cavity with one end directly placed in the left ventricle of the heart and the other end attached to the aorta (large blood vessel that is attached to the heart). The pump has a driveline, which is tunneled through the abdomen and exits through the abdominal wall. This driveline attaches to a controller and is powered by either AC adaptors or batteries. An external, wearable system that includes the small controller and two batteries can be worn under or on top of clothing.
Patients suffering with advanced heart failure who have exhausted medical therapies may be candidates to receive an LVAD. The American Association of Cardiology and the American Heart Association recommend this therapy as a viable treatment option for advanced heart failure. Clinical studies have shown that patients treated with an LVAD can live longer and enjoy an improved quality of life compared to medication management alone.
The LVAD is designed to restore blood flow throughout the body, enabling you to breathe more easily and have more energy. It can significantly reduce heart failure symptoms and improve quality of life. You should be able to resume normal activities that you were unable to do prior to receiving the device. Due to the external driveline, patients with an LVAD are unable to swim or submerge in water.
- Bridge to recovery: An LVAD can be used to support a patient who is experiencing heart failure that may reverse itself after temporary support, such as viral infections and post-partum heart disease, among others.
- Bridge to transplant: An LVAD can be used to support a patient until a donor heart becomes available.
- As destination therapy: An LVAD can be implanted permanently for long-term therapy in patients with severe heart failure who are not candidates for heart transplantation.
TriStar Centennial Heart and Vascular Center’s mechanical circulatory support program will determine if you are a candidate for this therapy after an extensive evaluation, which includes:
- Laboratory tests
- Diagnostic tests
- Psychosocial evaluation with patient and two designated caregivers
- Financial/insurance verification to confirm coverage and benefits
A multidisciplinary team including medical and ancillary healthcare providers will meet to review the results of the evaluation and determine the best option for each patient. Some patients will be deemed candidates for LVAD and/or transplantation, while others will be advised ongoing medical therapy or an alternative procedure.
Extra-corporeal membrane oxygenation (ECMO) is a form of partial cardiopulmonary bypass which can be used for extended periods in the intensive care unit. ECMO can temporarily replace the function of the failing heart, lungs, or both in order to allow a patient to recover from a potentially reversible severe critical illness. Here at TriStar Centennial Medical Center, we strongly believe in the power of this technology, and have successfully utilized it to save the lives of multiple patients who would have surely otherwise died. The following partial list of conditions may be appropriate for support with ECMO:
- Acute Respiratory Distress Syndrome (ARDS)
- Cardiogenic Shock
- Severe Refractory Asthma
- Massive Pulmonary Embolism
- Accidental Hypothermia, Drowning, or Poisoning
We have a comprehensive dedicated team made up of ECMO physicians, cardiologists, cardiovascular surgeons, intensivists physicians, perfusionists, and ECMO specialist nurses. We hold regular training courses and practice drills to ensure that our providers are always ready to care for these seriously ill patients. Our ICU is staffed 24/7 by board certified critical care physicians who are dedicated to caring for these most seriously ill patients. For patients interested in learning more about this procedure and scheduling an appointment, please call TriStar Centennial’s ECMO Hotline at 833 TN SHOCK or (833) 867-4625.
- Transplants: a procedure in which a failing diseased heart is replaced with a healthier heart, typically reserved for end stage heart failure when other traditional treatments have failed. Heart transplants require extensive evaluation, much like that of an LVAD, to determine candidacy for this procedure.
- Left atrial appendage closure (LACC): a device that reduces stroke risk in people with atrial fibrillation not caused by a heart valve problem. Different from oral blood thinners, LAAC is a permanent implant that closes off a part of the heart where blood clots commonly form.
- Transcatheter Mirtal Valve Repair: a device used to treat mitral valve regurgitation (leaky mitral valve) for individuals who should not have open-heart surgery. It is implanted via a catheter technique and involves “clipping” together the anterior and posterior mitral valve leaflets. The valve continues to open/close on either side of the clip and reduces the amount of blood flowing back into the left atrium.
- CardioMEMS: measures and monitors the pressure in the pulmonary artery and heart rate in certain heart failure patients.
- Inotropes: select patients may take these intravenous medications to help alleviate symptoms and stabilize heart function. Prolonged use requires insertion of an indwelling intravenous line and wearable pump.
- Palliative care and hospice: our hospital provides compassionate care to make patients feel as comfortable as possible during heart failure care.