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Cardiovascular

Heart Failure Program

When your heart can no longer efficiently pump blood throughout your body, you have a condition called heart failure. Heart failure affects more than 5 million Americans. It can lead to organ failure, as the body’s organs die when they don’t receive an adequate blood supply. Individuals with diabetes, high blood pressure or who have a history of heart attacks are especially at risk.

The Florida Hospital Cardiovascular Institute is one of the largest and best-regarded cardiac facilities in the whole world. In fact, the Florida Hospital Orlando cardiac program was recently rated the best in the state, and the 23rd best in the nation, by U.S. News & World Report. We serve more cardiology patients than anyone in the country, and perform more open-heart surgeries than anyone in the state. We’re also the only hospital in Central Florida, and the only facility in Adventist Health Systems, that performs heart transplants.

We specialize in advanced heart failure. Our Advanced Heart Failure Clinic treats and manages patients struggling with advanced heart failure, as well as individuals who are seeking to become eligible for heart transplants. We offer our patients access to skilled doctors who are on the cutting edge of their specialties. These physicians have the experience and expertise that gives our heart-failure patients peace of mind, knowing that they’re receiving some of the best care anywhere.

This is true no matter the patient’s income or health insurance status. Florida Hospital Orlando’s Advanced Heart Failure Clinic cares for patients who might not otherwise be able to afford treatment for their health problems.

Below, we’ll talk about some specific types of heart failure, and what the cardiac specialists at Florida Hospital Orlando will do to aggressively battle this form of heart disease.

Chronic Heart Failure

Chronic heart failure occurs when the heart’s pumping power is weaker than it should be. This condition forces the heart to worker harder to pump blood. In the short term, the heart can compensate, but as the disease progresses, it can no longer keep up. This condition can be caused by a number of cardiac conditions, including heart valve disease, a heart attack, diseases affecting the heart muscles, or conditions such as high blood pressure or kidney disease that overwork the heart.

Sometimes, your Florida Hospital Cardiovascular Institute doctor will recommend surgery to treat the underlying problem or problems causing the heart failure—for example, heart valve repair or replacement or coronary bypass surgery, which uses blood vessels harvested from elsewhere in the body to enable the blood to circumvent a blockage. Another option for patients with a poorly functioning left ventricle (the heart’s main pumping chamber) is the recently developed Dor Procedure. The institute’s surgeons traveled all the way to Italy to receive special training in this technique.

Medications may also be used to treat heart failure. These include:

  • ACE inhibitors, which lower blood pressure and reduce the heart’s workload.
  • Angiotensin II, a medication that works similarly to ACE inhibitors but has fewer side effects.
  • Beta-blockers, which slow the heart rate and lower blood pressure. These drugs can also help with some symptoms of heart failure.
  • Digoxin, which increases heart strength while slowing the heartbeat.
  • Diuretics, which control the buildup of sodium and fluid in the body, making it easier to breathe.

In some cases neither surgery nor medications will work, and for these heart failure patients, doctors may recommend a heart transplant. The Florida Hospital Cardiovascular Institute is the first and only facility in Central Florida with an advanced, comprehensive heart transplant program. Learn more in our Heart Transplant section.

Dilated Cardiomyopathy

Patients whose left ventricle (the heart’s primary pumping chamber) has become enlarged and can no longer effectively pump blood throughout the body have a condition called dilated cardiomyopathy. This is one of the most common causes of heart failure. Without treatment, dilated cardiomyopathy can be fatal, as the heart simply can’t pump enough blood to adequately supply the body’s organs and tissues.

The only cure for dilated cardiomyopathy is a heart transplant—the Florida Hospital Cardiovascular Institute is the only facility in Central Florida with a comprehensive heart transplant program—but there are other treatments available. A bi-ventricular pacemaker, for example, can be inserted into the upper chest near the collarbone. This pacemaker sends a stimulating signal to the heart whenever it stops or slows down, returning the heart to its normal rhythm. Another option, which is used in conjunction with a pacemaker, is an implantable cardioverter-defibrillator (ICD). This device stimulates the heart like a regular defibrillator, and has dramatically reduced the chance of death in dilated cardiomyopathy patients.

Medications that may be used to treat dilated cardiomyopathy include:

  • ACE inhibitors, which lower blood pressure and reduce the heart’s workload.
  • Beta-blockers, which slow the heart rate and lower blood pressure. These drugs can also help with some symptoms of heart failure.
  • Digoxin, which increases heart strength while slowing the heartbeat,
  • Diuretics, which control the buildup of sodium and fluid in the body, thus making it easier to breathe.
  • Anticoagulants such as warfarin and heparin, which help prevent blood clots that can lead to stroke in dilated cardiomyopathy patients.
  • Antiarrythmics, which control the heart rate whenever a patient has abnormal, rapid heartbeats.

Heart Transplant

In February 2012, Edwin Arce, 49, of Orlando, became the first patient to receive a new heart at the Florida Hospital Transplant Institute, which houses Central Florida’s first and only comprehensive heart transplant program. Arce, a non-ischemic myopathy patient, had struggled to walk from his bed to his couch, and had been waiting on a new heart for months. Today, he has a new lease on life.

This surgery and the heart transplants that have followed are the culmination of Florida Hospital Orlando’s commitment to offering our neighbors who are battling end-stage heart disease access to the finest transplant surgeons and the highest level of cardiac services anywhere, right in their backyard.

Florida Hospital Orlando began laying the groundwork for its heart transplant program in 2008. We’ve since brought in renowned physicians from all over the world, including Dr. Hartmuth Bittner, Dr. Barbara CzerskaDr. Ahmad Z. Chaudhryand Dr. Donald M. Botta, as well as some of the top nurses, paramedics and supporting staff in the area.

The Florida Hospital Transplant Institute specializes in advanced heart failure, cardiac transplant and mechanical circulatory support programs. Patients referred to the Florida Hospital Transplant Institute usually have advanced heart disease or irreversible heart damage. While medical treatments or therapies may alleviate their symptoms, they cannot cure the heart disease. Only a transplant can do that.

Before, these patients would have had to travel somewhere else, sometimes far away, to receive a new heart. Not anymore.

The skilled team at the Florida Hospital Transplant Institute evaluates every single case to see which advanced heart failure therapies, including heart transplantation, will work best. Not every patient will be eligible for a heart transplant. Below are the criteria our experts use in assessing candidates for heart transplantation:

  • Under the age of 70 (patients who have not reached their 70th birthday are considered eligible)
  • Do not have a major disease that will diminish their chances of long-term survival
  • No evidence of active cancer in the past five years (there may be exceptions)
  • Free of drug, alcohol and tobacco use for the past six months, and committed to remaining abstinent throughout the transplant process
  • No evidence of extensive vascular disease affecting the patient’s brain, circulation or major arteries
  • Support network to assist with the tests, exams and assistance required in the pre- and post-treatment phases
  • Able to follow instructions related to treatment, medications, appointments and education meetings
  • Adequate insurance to cover the medications needed to prevent transplant rejection
  • Psychological commitment to actively participating in the transplant process

Patients who have a heart transplant will need to take medications called immunosuppresants. These drugs are designed to prevent the body’s immune system from rejecting the new heart.