Clinical Briefing: Heart Failure and Transplantation Program
January / February 2006
Clinical, research and educational expertise enable the
Heart Failure and
Transplant Program at Penn to meet the
complex needs of patients with moderate to severe heart failure. “I
think the single most important thing about Penn is the breadth
and depth of experience. For any cardiac condition a patient
may have, there is an expert at Penn. A surgical program
is nothing without strong cardiology support, and an excellent
cardiac program, which by definition, includes a superb surgical
team. They are one and the same, and dependent on each other
for the total care of the patient,” said Mariell
L. Jessup, MD, Medical Director of the Heart Failure
and Transplantation Program.
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The Heart Failure and Transplantation
Program at the Hospital of the
University of Pennsylvania (HUP) has
performed the highest number of heart
transplant procedures than all
Philadelphia area hospitals combined
and more than any hospital in the state
of Pennsylvania. According to the
Organ Procurement and Transplantation
Network (OPTN) and the Scientific
Registry of Transplant Recipients
(SRTR), HUP ranks in the top six
nationally for heart transplants. HUP is
also recognized as being one of three
Heart/Lung Transplant Programs in the
state of Pennsylvania.
*Data from OPTN/SRTR
Center and OPO specific reports (July 2005);
Organ Procurement and Transplantation Network
and Scientific Registry of Transplant Recipients
available at
www.ustransplant.org. |
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Case Study
Mr. S. is a 60 year-old man with a history of ischemic
heart disease. His heart failure exacerbations worsened
in occurrence and severity over several months despite
intensive management by his primary cardiologist. His
physician referred him to the Heart Failure and Transplant
Program at the Hospital of the University of Pennsylvania
(HUP) for a high-risk surgical revascularization evaluation.
After a complete review of the patient's coronary
data, the multidisciplinary Heart Failure and Transplantation
team determined that the surgical risk outweighed any
potential benefits.
The team met with Mr. S. and his wife to discuss medical
management options. The ultimate goal was to improve the
patient's functional capacity. The plan included enrollment
into the HF-Action clinical trial, routine visits to HUP
and phone triage with an assigned heart failure nurse. Additionally,
Mr. S. and his wife met with a financial coordinator to assist
them with insurance issues. They also met with a social worker
to help them address the chronic illness challenges they
faced.
His condition further worsened after several months. The
Heart Failure team reconvened and determined Mr. S. was now
an appropriate candidate for heart transplant. During the
waiting period, his listing status was upgraded when his
condition warranted inotropic support. Mr. S. underwent a
successful heart transplant five weeks later.
Mr. S. spent two days of post-surgical recovery in the Cardiothoracic
Surgical Intensive Care Unit and was then transferred to
the Cardiothoracic Surgical floor. Following thorough heart
transplant care coordination with the patient and his family,
Mr. S. was discharged to home. Mr. S. is on a close follow-up
schedule that includes routine endomyocardial biopsies. He
started cardiac rehabilitation eight weeks post transplant
and is setting new goals for his renewed life.
Clinical Trial: HF-ACTION
Heart Failure and A Controlled Trial Investigating Outcomes of Exercise TrainNing
(HF-ACTION) is a landmark study evaluating the effect of exercise training
on mortality and morbidity in heart failure patients.
This National Heart, Lung and Blood Institute - (NHLBI)
funded trial randomly assigns 3,000 patients with moderate
to severe heart failure to either standard medical therapy
and education, or standard medical therapy and education
plus a supervised exercise program. The exercise training
includes 36 supervised clinic-based training sessions followed
by home-based exercise and periodic supervised sessions for
reinforcement, with all patients receiving follow up for
three years.
The Heart Failure and Transplant Program is currently enlisting
new patients for their ongoing clinical trials. For more
information on the latest in clinical research, please call
(215) 615-0815.
Our Team of Faculty
The Heart Failure and Transplantation Program at Penn provides
comprehensive care for patients with heart failure offering
more treatment options than ever before. Our multidisciplinary
team includes some of the nation's finest cardiologists,
cardiothoracic and transplant surgeons, specialized nurses,
social workers, physical therapists, and support staff
who provide coordinated care throughout the entire transplant
process. Our goal is to meet the unique physical and emotional
needs of each patient in a caring, professional environment.
The ambulatory care center is located in Penn Tower, across
from the Hospital of the University of Pennsylvania. In
continuing to meet the goals of providing centralized outpatient
care services for heart failure and cardiac transplant patients,
this location offers convenient cardiac care services for
physician and nursing visits, echocardiography, phlebotomy,
endomyocardial biopsies (post-transplant patients), exercise
testing, financial counseling, social services and research.
Parking is available at
the same location.
Cardiothoracic Surgery
Rohinton
J. Morris, MD,
Surgical Director, Heart Transplantation
and Mechanical Assist Programs
University of Pennsylvania Health System
Michael
A. Acker, MD,
Chief, Division of Cardiothoracic Surgery
Hospital of the University of Pennsylvania
Alberto
Pochettino, MD,
Director, Heart/Lung Transplant Program
Hospital of the University of Pennsylvania
Y.
Joseph Woo, MD,
Hospital of the University of Pennsylvania
Cardiology
Mariell
L. Jessup, MD,
Medical Director,
Heart Failure/Transplant Program
Hospital of the University of Pennsylvania
Susan
C. Brozena, MD,
Associate Director,
Heart Failure/Transplant Program
Hospital of the University of Pennsylvania
Thomas
P. Cappola, MD,
Hospital of the University of Pennsylvania
Brian
M. Drachman, MD,
Penn Presbyterian Medical Center
Daniel
L. Dries, MD,
Hospital of the University of Pennsylvania
Lee
R. Goldberg, MD,
Medical Director, Heart/Lung Program
Hospital of the University of Pennsylvania
Kenneth
B. Margulies, MD,
Research Director, Heart Failure/Transplant Program
Hospital of the University of Pennsylvania
Ross
S. Zimmer, MD,
Medical Director, Heart Failure Program
Penn Presbyterian Medical Center
Transplant Nurse Practitioners
Patricia Curry-Stutman,
MSN, CRNP
Susan Chambers, MSN, CRNP
Frances Rogers, MSN, CRNP
Nicole Viger, MSN, CRNP
Mary Williams, MSN, CRNP
Social Work
Deborah Gordon, MSS, CSW
Elizabeth Shore, MSW, CSW
Financial Coordinator
Michele Harmon
Clinical Manager
Donna Chojnowski, MSN, CRNP
Access
Patient appointments are available at:
Hospital of the University
of Pennsylvania
6 Penn Tower
3400 Spruce Street
Philadelphia, PA
Penn Presbyterian Medical Center
Philadelphia Heart Institute,
Suite 400
39th and Market Streets
Philadelphia, PA
To refer a patient and/or consult
with a doctor:
Please
contact your UPHS physician
liaison with any concerns or problems you may experience
when referring
your patient.
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