Advanced Heart Failure Treatment

What Is Advanced Heart Failure? 

Advanced heart failure, also known as Stage D or end-stage heart failure, is a progressive condition that worsens over time despite standard treatment and lifestyle changes. It occurs when the heart becomes too weak or stiff to pump enough blood to meet the body's needs.  

Common causes include coronary artery disease, high blood pressure, heart rhythm problems and inherited heart muscle disease. While advanced heart failure cannot be cured, specialized treatment can help stabilize the condition, relieve symptoms and improve quality of life.

Experience You Can Count On 

At UC San Diego Health, you'll receive comprehensive care from nationally recognized specialists with extensive experience treating advanced heart failure. We provide seamless, coordinated care for patients from across San Diego County and beyond.  

Full Spectrum of Advanced Treatment Options 

• Mechanical circulatory support (MCS): This treatment includes extracorporeal membrane oxygenation (ECMO) and left ventricular assist devices (LVADs). UC San Diego Health is one of only three health systems in San Diego offering VAD therapy. Our patient success outcomes exceed national averages. 
• Heart transplant: Our heart transplant program is the largest in San Diego and the third largest in California, placing it among the nation's top-performing transplant centers. Our patient survival rates for heart transplants exceed the national average. 

Exceptional Patient Outcomes 

Our cardiovascular program delivers excellent outcomes, including higher survival rates, shorter hospital stays and fewer patients needing to return to the hospital within 30 days than at leading heart hospitals across the country. 

National Recognition, Personalized Care  

Our heart and vascular program is ranked No. 15 in the nation by U.S. News & World Report. Our experienced, multidisciplinary care team includes top-ranked heart failure specialists, cardiac imaging specialists, heart rhythm specialists (electrophysiologists), interventional cardiologists, heart surgeons (cardiothoracic surgeons), pharmacists, nurse practitioners and social workers. Together, they customize your treatment plan based on your symptoms, overall health and treatment needs.  

Expertise in Complex Heart Conditions 

We care for people with complex, inherited and difficult-to-treat heart conditions, including cardiomyopathies and other conditions that can lead to advanced heart failure. Our specialists use advanced imaging and diagnostic tools to better understand your condition and guide your treatment. 

Access to Clinical Trials and Innovative Therapies 

As San Diego's only academic medical center, UC San Diego Health offers access to more than 50 clinical trials for advanced heart failure.  

Eligible patients may participate in studies of precision medications, gene-based therapies, advanced heart devices, minimally invasive procedures to improve heart function, and other emerging treatments before they are widely available. Our research includes studies for common, complex and inherited forms of heart disease, including certain cardiomyopathies and rare heart muscle diseases.  

Advanced Heart Failure Treatment Options 

Advanced heart failure treatment depends on your symptoms, heart function and overall health. When standard medications are no longer effective, your care plan may change over time and may include one or more of the following specialized options. 

Mechanical Circulatory Support 

Mechanical circulatory support (MCS) involves the use of implanted or external devices to take over or help the pumping function of a weak heart. These devices, which may help when other therapies are no longer enough, include: 

• ECMO: Extracorporeal membrane oxygenation (ECMO) involves a life-support machine that temporarily does the work of the heart and lungs for patients in severe cardiac failure. This treatment helps stabilize patients while doctors determine long-term treatment. 
• LVAD: A left ventricular assist device (LVAD) is a mechanical pump that is surgically implanted in the chest to help the heart circulate blood to the rest of the body. An LVAD may be used as a bridge to transplant while waiting for a donor heart or as long-term support for patients who don't qualify for transplant. 

Heart Transplant 

For some people with severe advanced heart failure, heart transplant may be a lifesaving option. This surgery replaces a failing heart with a healthy donor heart when other medical or surgical treatments are no longer effective. 

The process involves a thorough evaluation, placement on a national transplant waiting list, surgery and lifelong anti-rejection medications to help protect the transplanted heart. 

Advanced Heart Failure Diagnosis 

Before recommending treatment, our advanced heart failure care team will review your symptoms, medications, previous heart tests and hospital stays. We also discuss your goals, concerns and quality of life with you and your caregivers.  

Because heart failure symptoms can vary from person to person, we take a careful, individualized approach to evaluation. This is especially important for women, whose symptoms may be more likely to be mistaken for stress, aging or anxiety, potentially delaying diagnosis and referral. 

Your evaluation may include:  

• Review of your medical history and current medications 
• Blood tests and heart imaging 
• Tests to assess heart function and blood flow  
• Discussion of treatments that may be appropriate for you  

Advanced Heart Failure Locations

UC San Diego Health offers advanced heart failure care at multiple locations throughout San Diego County.