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The goal in the Heart Failure and Transplantation rotation is to provide fellows a focused experience in this area of cardiology and emphasize the available interventions, both surgical and non-surgical, for the end-stage heart failure patient. Fellows will become expert in the management of mild-to-moderate heart failure in the outpatient clinics. Exposure to the most severely decompensated patient comes in the in-hospital setting through inpatient rotations on the dedicated heart failure inpatient service, which includes patients in the CCU and step-down Division. Fellows work closely with the program faculty, which includes Drs. Leway Chen, Jeffrey Alexis, Eugene Storozynsky, Sabu Thomas & Himabindu Vidula.

The specific learning objectives, designed for the fellow, provide an in depth working knowledge of two main areas – heart failure and heart transplantation. Within these areas the fellow is expected to expand his knowledge base on a number of specific topics and develop competence in formulating a treatment regimen for individual patients. At the completion of the Heart Failure and Transplantation Fellowship, the fellow will be able to

Heart Failure

  1. Describe the pathophysiology of cardiac failure.
  2. Understand the initial clinical approach, both diagnostically and therapeutically, to the new patient with heart failure.
  3. Discuss the evidence base from randomized clinical trials, which demonstrate the efficacy of various drugs in the treatment of specific patients with heart failure.
  4. Understand the indications for pacemakers, defibrillators, and pharmacologic therapy in the treatment of heart failure patients with arrhythmias or conduction abnormalities.
  5. Understand surgical options for improvement of symptoms and life expectancy in the heart failure patient.
  6. Understand the role of ventricular assist systems as bridge to recovery and destination therapy.

Cardiac Transplantation

  1. Understand the indications for cardiac transplantation.
  2. Identify diagnostic tests that are important in evaluating patients for heart transplantation.
  3. To be come familiar with pre-operative management of the patient with severe heart failure who is awaiting transplantation.
  4. To understand the role of ventricular assist systems in bridging patients to transplantation.
  5. To become familiar with performing diagnostic right heart catheterizations and endomyocardial biopsies.
  6. To understand the appropriate management of the post-transplant patient, including managing immunosuppression and post-transplant complications.

The educational goals are achieved by the fellow working directly with patients who are seen in the inpatient setting. The fellow works in conjunction with faculty in the Program in Heart Failure and Transplantation. The faculty member directly responsible for fellow education is Leway Chen, MD, MPH.