Advanced Heart Failure and Transplant Cardiology Inpatient Service

The Advanced Heart Failure and Transplant Cardiology (AHFTC) service is housed at CPMC's Van Ness Campus.  Our multidisciplinary team cares for hospitalized patients with heart failure and those whom have received or are being evaluated for advanced heart failure therapies.  The fellows play an integral role in the evaluation and management of our patients.  In addition, there is a supervisory and teaching role to the cardiovascular disease fellows who rotate through the service.  The inpatient clinical experience is robust and comprehensive with exposure to all aspects of the management of advanced heart failure and cardiogenic shock.  Experience includes the evaluation and management of temporary and durable mechanical circulatory support including ECMO.  Fellows will also gain comprehensive experience in the early post-operative and long-term management of post heart transplant and LVAD patients and their complications.  

CPMC VNC Heart Failure, Transplant and Ventricular Assist Device Clinic

CPMC VNC Clinic offers a comprehensive outpatient clinical experience in heart failure, heart transplant and durable mechanical circulatory support.  Fellows will rotate through dedicated clinics in these areas to gain clinical experience and the skills necessary to longitudinally manage these patients.  Fellows will also participate in the outpatient evaluation of heart failure patients whom are being considered for advanced heart failure therapies.  Fellows will also have the opportunity to function as an educator to CPMC cardiovascular disease fellows and internal medicine residents that rotate through the clinic.   

Palo Alto Medical Foundation – San Carlos, Multidisciplinary Heart Failure Clinic

The outpatient multidisciplinary heart failure clinic (MDHF) at the Palo Alto Medical Foundation San Carlos Center is a unique approach to managing chronic and advanced heart failure. The care for the heart failure patient has become increasingly complex and multifaceted, patients in this clinic have access to the clinical expertise of pharmacists, dietitians, exercise physiologists, nurse educators, genetics counselors and heart failure cardiologists. Each visit is tailored to the individual needs of the patient and includes a robust functional and clinical assessment including cardiopulmonary exercise testing. In addition, local post-surgical LVAD and transplant patients are followed in this clinic. At least one advanced heart failure faculty is present for each MDHF clinic. The educational impact here is significant as this clinic structure is truly a robust, unique, multidisciplinary approach to managing patients heart failure.

Procedural Training

Fellows will gain adequate clinical experience in the performance and interpretation of invasive and noninvasive cardiac studies including:

• Endomyocardial Biopsy
• Diagnostic Catheterization
• Cardiopulmonary exercise testing
• CIED Device Interrogation and Management
• CardioMEMS implantation

Conferences and Educational Sessions

• Advanced Heart Failure Core Curriculum
• Heart Failure Journal Club
• Multidisciplinary Clinical Conference, Division of Cardiology
• Transplant and MCS Selection Conference
• Heart Failure and MCS patient Clinical Review Meeting
• Cardiology Division Grand Rounds
• Internal Medicine Grand Rounds
• Cardiology Quality and Process Improvement Meeting
• Pathology Endomyocardial Biopsy Review