In This Section

Cardiac Surgery

  • Heart Failure Surgery

Mechanical Circulatory Assist

Hear from Dr. Katz and Dr. Caranasos on the innovative clinical trials offered at UNC Heart & Vascular that involve mechanical circulatory assist devices.

Watch video

Heart Failure Surgery

Congestive heart failure (CHF) is a condition in which a weakened heart is unable to supply sufficient blood to the body. It may be caused by a heart attack (myocardial infarction) or heart-muscle wasting (cardiomyopathy). Each year, over half a million new cases of congestive heart failure are diagnosed.

At UNC, we have several surgical options for heart failure patients, in addition to medical therapies. Because congestive heart failure is a complex disease with many possible treatment options, each patient at UNC benefits from having a team of heart and vascular specialists working together to evaluate his or her condition, and determine the best course of therapy. Following are the surgical options currently available at UNC:

  • Heart and heart/lung transplant
  • Low ejection fraction (EF) coronary bypass grafting (CABG)
  • Low EF aortic valve replacement
  • Low EF mitral valve repair
  • Ventricular reconstruction for akinetic and aneurysmal heart muscle
  • Biventricular lead placement for pacemakers
  • Placement of a mechanical circulatory support device

Heart Transplant

Heart transplantation remains the gold standard for patients with end-stage heart disease, and the only true cure for the disease. With anti-rejection medicines, patients are often able to return to an excellent quality of life and have a survival rate of over 50% 10 years after transplant.

At UNC, we’ve performed over 250 heart and heart/lung transplants. The transplant team includes doctors, nurses, social workers, psychologists, and financial coordinators. Potential candidates for transplant are first evaluated by one of a team of UNC heart failure cardiologists, all of whom meet weekly in a multi-disciplinary setting to identify patients who may need to become listed for a heart transplant.

From there, the final decision to put someone on our transplant list is a multi-step process that includes a formal evaluation to make sure the individual is medically and psychologically appropriate for transplant. Because the number of hearts available for transplant is extremely limited, our goal is to perform transplants on patients most likely to benefit for the longest period of time. To that end, the following tests are conducted:

  • A formal evaluation by our transplant social worker
  • A formal evaluation by our transplant psychologist
  • Blood testing for hepatitis, HIV, and other immune sensitivities
  • A pap smear and mammogram for women
  • A PSA for men
  • A colonoscopy for individuals over 50 years old
  • A right upper quadrant ultrasound
  • A right-heart catheterization
  • Pulmonary function tests
  • A chest X-ray
  • An echocardiogram

Mechanical Circulatory Assist

Despite the best medical and surgical therapies available, a certain group of patients will continue to have symptomatic end-stage heart disease. Many of these patients are candidates for artificial circulatory support.

At UNC, we implant several different mechanical circulatory devices. The devices we use can support either the acutely or the chronically decompensated heart. We have the ability to support just the left ventricle (LVAD – Left Ventricular Assist Device) or to support both the right and left ventricles (BiVAD – Biventricular Assist Device).

The most common use for these devices is to bridge the failing heart until a transplant can be performed. Many patients will only require left ventricular support for heart failure. However, there are some cases where both the right and left ventricles require support with a device. The equipment for the different devices we use is all different, but each has the common purpose of assisting the failing heart in delivering a better blood supply (i.e. cardiac output) to the body.

There is a very special group of patients with severe CHF who are not transplant candidates. However, they may be candidates for an LVAD for destination therapy, that is, a device implanted to remain in place as a heart failure treatment for the remainder of their lives. UNC has the distinction of being a Medicare/Medicaid approved Destination Therapy Center.

At UNC, we use several devices for assisting the failing heart:

The Thoratec allows us to support either the left ventricle (LVAD) or both the right and left ventricles (BiVAD). The HeartMate XVE is a device approved by the FDA to be used either as a bridge to transplant or as a destination therapy device.

The Jarvik 2000 is a much smaller axial flow pump that can be placed using a surgical technique that does not require use of cardiopulmonary bypass (heart and lung machine). It also has the advantage of being implanted through an incision in the left chest, not through the sternum (breastbone). The Jarvik 2000 is used as a bridge to transplant.

Patients receiving any of these devices can be discharged to home after appropriate teaching of the equipment has taken place. Patients are also sent to the inpatient rehab unit at UNC prior to returning home so they can gain more strength, endurance and independence.

While there are many cardiac surgery and heart transplant centers in the southeast, UNC is one of only two centers in North Carolina, South Carolina, Georgia, eastern Tennessee, and southern Virginia approved to provide destination therapy as treatment of severe CHF.

More Information about Congestive Heart Failure


Andy C. Kiser, MD
Brett Sheridan, MD

Contact Us

Call the Heart & Vascular Center referral line at 866-862-4327 to find specialists, make an appointment or learn more about preventing heart disease.

Open Access is a new physician referral service, created by the UNC Center for Heart & Vascular Care, which coordinates all admissions and transfers through a single phone call and guarantees immediate acceptance for patients. Please contact us to learn more or call 866-862-4327.

Related Locations