When referring heart failure patients, earlier is better

Waiting too long to refer a heart failure patient can result in kidney dysfunction, liver dysfunction, right ventricular failure and overall poor outcome.

Knowing when to refer a heart failure patient for specialist care can be crucial, according to Bassel Alkhalil, M.D., medical director of Norton Heart & Vascular Institute’s mechanical circulatory support program.

In general, earlier is better. Even though heart failure patients are often the sickest of the sick, according to Dr. Alkhalil there is a lot a heart failure specialist can do to improve the lives of their patients.

“There is a window of opportunity beyond which heart failure patients tend to progress,” he said.

Waiting too long can result in kidney dysfunction, liver dysfunction, right ventricular failure and overall poor outcome.

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At Norton Heart & Vascular Institute’s Advanced Heart Failure and Recovery Program, the initial step is to try to improve cardiac function with guideline-directed medical therapy. If that fails and patients meet criteria, according to Dr. Alkhalil, he and his colleagues will raise the possibility of a left ventricular assist device (LVAD) or heart transplantation.

Additionally, Norton Heart & Vascular Institute providers can use extracorporeal membrane oxygenation (ECMO) to support patients while treating severe cardiac and/or respiratory failure or as a bridge to a transplant.

“ECMO has been a great addition to our growing mechanical circulatory support program,” Dr. Alkhalil said.

The most rewarding moments

Without treatment, half of heart failure patients die within five years. For Dr. Alkhalil, his goal is always to change the trajectory of these patients’ lives. With medical management, many heart failure patients can live longer, with better quality of life.

“There is nothing more rewarding for me than treating a patient and have them say, ‘I feel so much better now,’” Dr. Alkhalil said. “When someone’s family comes to me saying, ‘We couldn’t have done it without your help,’ I really feel good.”

Dr. Alkhalil joined Norton Heart & Vascular Institute earlier this year. He did his medical training and postdoctoral fellowship at Harbor Hospital and Johns Hopkins University, in Baltimore, Maryland. He then completed both a fellowship in advanced heart failure and cardiovascular diseases at the University of Louisville, then practiced at a Louisville hospital. He said he chose Norton Healthcare because of the phenomenal, patient-centric team.

Originally from Syria, Dr. Alkhalil attended the University of Damascus School of Medicine before completing his medical residency at Harbor Hospital, which is affiliated with Johns Hopkins University and the University of Maryland.


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