Course Overview
Despite advances in diagnostic and therapeutic options, heart failure has reached epidemic proportions. More than 4.8 million Americans currently have heart failure and 400,000 to 700,000 new cases develop each year: The tremendous increase in the number of heart failure patients and the lack of sufficient treatment options, have increased the need for physicians to use mechanical support devices. Because development of this therapy has been the domain of cardiovascular surgeons, cardiologists have not always been familiar with these devices and their applications. However, now that mechanical support is being prescribed for permanent use or for bridging to recovery, cardiologists are beginning to see the enormous potential offered by these devices. Indeed, the involvement of cardiologists is imperative for the further development and evolution of circulatory support systems.

Educational Objectives
The intended result of this activity is increased knowledge. At the conclusion of this program, participants will be able to

• Assess the current heart assist devices available to heart failure patients.
• Explain the effects of partial unloading when treating acute, decompensated heart failure.
• Discuss the applicability of percutaneous devices by cardiologists in the catheterization lab.
• Describe adjunctive modalities for treating heart failure including stem-cell therapies.
• Critically assess when to use medical support in AMI shock.
• Summarize the indications for surgical support and determine when to refer patients for device therapy.

Target Audience
This enduring material is intended for cardiologists, cardiovascular surgeons, clinical researchers, sub-specialty trainees, nurses, and hospital administrators.

Additional Resources
Mechanical Circulatory Support: A Texas Heart Institute Perspective
http://texasheart.org/education/cme/explore/events/eventdetail_5103.cfm

Mechanical Circulatory Support for Advanced Heart Failure
http://circ.ahajournals.org/cgi/content/full/108/25/3064

Evaluation / Feedback
We value your comments; please send your suggestions and comments to the office of continuing medical education at the Texas Heart Institute.

Accreditation Statement
Texas Heart Institute is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Texas Heart Institute designates this educational activity for a maximum of 2 AMA PRA Category 1 Credits™. Each physician should claim only those hours of credit that he/she actually spent in the activity.

The estimated time to complete this activity, including review of the materials is 2 hours.

Term of Approval 
April 2006 through April 2009. Original release date: April 6, 2006.

Peer Review
In March 2006, this continuing medical education activity was reviewed by James J. Ferguson III, MD, FACC—Associate Director, Clinical Cardiology Research, THI; Co-Chairman, Medical Education Committee, THI; Chairman, Research Committee, THI. Houston, TX. In order to ensure the continued relevance of this activity it was reviewed again by Dr. Ferguson in August 2007.

Disclosure of Relationships
Each Faculty disclosure statement is posted in the individual slide presentation.

It is the intent of the Texas Heart Institute to assure that its educational mission and its continuing medical activities in particular, should not be influenced by the special interests of individuals associated with its program.  The Institute’s policy requires that the activity director, planning committee, and faculty disclose all relationships with commercial interests.  Faculty is also required to disclose any discussion of unlabeled use or investigational use of pharmaceutical and medical device products. When discussing therapeutic options, the presenter should use generic names.  If it is necessary to use a trade name, then those of several companies should be used.

In accordance with the guidelines of the Accreditation Council for Continuing Medical Education, these faculty members have disclosed the following relationships with either one or more of the manufacturers of commercial products discussed or with either one or more of the corporate organizations offering educational grants for this continuing medical education activity.

Roberta C. Bogaev, MD is a consultant for Thoratec Corporation, Guidant Corporation, Abiomed, Inc., World Heart, Initiate, American Heart Association, and Baptist Health System.  She is a member of the Speaker’s Bureau for Thoratec Corporation, Guidant Corporation, Initiate, American Heart Association, and Baptist Health System.

Reynolds M. Delgado III, MD is a member of the Speaker’s Bureau for NitroMed and GlaxoSmithKline.  He is an advisor for Guidant Corporation.

Marvin A. Konstam, MD is an officer/director for Orqis Medical, and as such, receives a salary from the company.  Dr. Konstam is also a stockholder in Orqis Medical.

Branislav Radovancevic, MD is a consultant for Abiomed, Inc., Orqis Medical, and Thoratec Corporation.

Other faculty members have declared no affiliation or financial interest in the manufacturers of commercial products discussed or with corporate organizations offering educational grants for this continuing medical education activity.