Heart Failure and Transplantation

There is a growing epidemic of heart failure in the United States, with more than five million individuals suffering from this condition according to the latest estimates from the American Heart Association.  Even with the availability of effective medical therapies, heart failure continues to be a deadly condition and leads to a significant reduction in quality of life due to the symptoms as well as frequent hospitalizations.

The mission of the Advanced Heart Failure and Transplant Program at the Cardiovascular Division of the University of Miami, Miller School of Medicine, is to provide comprehensive management of heart failure for all stages of the disease.  At the foundation is a disease management program that maximizes quality of life and minimizes the need for hospitalization.  The assembled team of physicians and nurses is also able to offer every possible therapeutic option that is available today, including the latest medical and device therapies such as stem cell repair and, if necessary, transplantation.  The program's goal is to provide the most outstanding and up-to-date care for patients with heart failure, whether they reside in the U.S. or abroad.

Research has shown that a comprehensive program in disease management can significantly improve longevity and overall quality of life, while reducing the financial burden on patients and the need to be hospitalized.  A high-quality disease management program also insures that patients have access to the most effective medications for heart failure, including medications by mouth and, if needed, intravenous medications.

For patients who develop more symptomatic and progressive heart failure, there are a number of medical devices that can be employed.  Some patients can use an advanced pacemaker called a biventricular pacemaker that allows the heart to beat in a more coordinated and efficient fashion.  Other patients may have dangerous heart rhythms or have a high risk for developing dangerous rhythms.  For these individuals, we can implant a defibrillator that continually monitors the heart.  If a dangerous rhythm is detected, the device can reset the heart. Finally, in more extreme situations with continued progression of heart failure, we can implant a ventricular assist device, or VAD.  The VAD can be thought of as a miniature pump that helps a failing heart to pump blood to the body.  These devices can either be used temporarily as a bridge to a heart transplant, or they can be permanent, so called "destination therapy."

One unique aspect of the University of Miami Miller School of Medicine’s Advanced Heart Failure and Transplant program is the option of stem cell therapies.  While not available as a standard treatment option at this time, these stem cell therapies are now being used in our new clinical trials to replace and repair failing heart muscle.  In appropriate subjects, researchers harvest their bone marrow and grow them in culture.  At the time of coronary artery bypass surgery or cardiac catheterization, the subject’s own bone marrow cells are injected into areas of failure heart muscle or scar to regenerate and repair the heart.

Finally, in the event of worsening disease that does not respond to any other therapies, we can offer patients heart transplantation.  The Transplant Team is a highly trained and experienced group of cardiologists, surgeons and nurses.  We are the only heart transplant program in South Florida, and we have been successfully performing and managing transplant patients for more than 20 years. 

With the wide array of therapeutic options available for patients with heart failure, the Advanced Heart Failure and Transplant program is able to offer a tailored approach to managing this disease.  Our program includes not only clinicians, but researchers to drive the creation of new treatments for heart failure.

The Advanced Heart failure and Transplant program is led by Dr. Ray E. Hershberger, M.D., and includes:

If you are a patient who would be interested in a consultation, please contact us at (305) 243-5554.

If you are a physician, please call our Cardiology Access Line at (305) 243-8300 so that we can direct you to one of our faculty Doctors.