Departments

The Cardiovascular Disease and Pregnancy Program at Yale offers comprehensive and individualized support before, during, and after pregnancy for people with heart conditions. Our mission is to improve outcomes in pregnancy for patients with either pre-existing or newly diagnosed heart disease and ensure that pregnant patients receive appropriate and specialized risk assessment, treatment, and support. Cardiovascular disease is the number one cause of maternal mortality in the United States. While most people with pre-existing cardiovascular conditions can safely and successfully become pregnant, carry a baby to term, and breastfeed, patients with cardiovascular conditions are at higher risk of complications during pregnancy and after delivery. Pregnancy can also reveal or cause previously undiagnosed heart problems, and certain pregnancy complications can put patients at a higher risk for future cardiovascular disease. Yale’s Cardiovascular Disease and Pregnancy Program brings together cardiologists, maternal-fetal medicine specialists , nutritionists, pharmacists, lactation consultants , social workers, and family planning specialists who utilize their unique expertise to provide comprehensive patient care. Our multidisciplinary team meets regularly to create individualized care plans for each pregnant patient with heart disease. We provide care to: People with known heart disease, including congenital heart disease and acquired heart diseases, such as abnormal heart rhythms (arrhythmias), heart failure, and ischemic heart disease (coronary artery disease) People who develop cardiovascular disease or are newly diagnosed with heart disease during pregnancy (for example, peripartum cardiomyopathy) People who develop pregnancy-specific complications (including preeclampsia and related hypertensive disorders or gestational diabetes) that put them at higher risk for future cardiovascular disease Before pregnancy Contraception counseling: We provide individualized contraception counseling to patients with cardiovascular conditions to help determine the best and most reliable form of contraception for them based on a variety of factors, including specific heart conditions, interaction with other medications, and personal preferences. Comprehensive risk assessment: We provide a comprehensive risk assessment for patients with heart conditions who wish to become pregnant. We coordinate care to ensure they receive updated imaging and diagnostic studies and are on pregnancy-safe medications before they conceive. We also work closely with patients to provide nutrition and exercise guidance. Preconception counseling: We provide consultations to explore and discuss a potential pregnancy and family building. During this visit, we will answer all patient questions and develop care recommendations to support patients prior to, during, and after pregnancy. We also introduce members of the care team. During pregnancy Prenatal care management: We work wi

Our program offers innovative care for patients with advanced and complex structural heart disease. From diagnosis to treatment, our team is dedicated to treating all forms of structural heart disease, some of which are congenital, or present at birth, and others that develop with age. We take the utmost care in treating these defects, which can affect the interior walls of the heart, the valves inside the heart, and the arteries and veins that carry blood to the rest of the body. As the first program in the state of Connecticut dedicated to the care of adult patients with complex congenital heart disease, we offer the full spectrum of care, providing regular inpatient and outpatient services to adult congenital heart patients. We offer an array of imaging, exercise testing, and surgical options, as well as less invasive catheterization therapies. Our multidisciplinary team includes interventional experts in congenital cardiac catheterization and electrophysiology who have decades of combined experience in the field. Our cardiothoracic surgical team has expertise in congenital heart disease and adult cardiac surgery with experience that spans three decades. Other members of the team include experts from the Yale General & Advanced Heart Failure Program, as well as a wide array of subspecialists in related areas, including liver and kidney disease. Adolescents and adult patients can expect to receive detailed education about their underlying congenital heart defect, its management, and the implications for future functioning. We ensure that our patients with pediatric congenital heart disease will be managed in the context of adult medicine with a multidisciplinary team that includes pediatric and adult cardiologists, adult pulmonologists, genetic counselors, and social workers. Our center provides state-of-the-art diagnostic imaging, including echocardiography and MRI. We work closely with Yale Medicine High-Risk Obstetric and Maternal-Fetal Medicine Programs to provide obstetrics and perinatology services to women with congenital heart disease, and we provide referrals for fetal echocardiography in cases where it is appropriate.

A pioneer in minimally invasive therapies for congenital heart disease, the Pediatric Interventional Cardiac Catheterization Program at Yale performs diagnostic and interventional catheterization procedures on patients with congenital heart disease from childhood into adulthood. We perform a variety of procedures including closures of atrial septal defect, patent foramen ovale, and patent ductus arteriosus. Ours is the only congenital cardiac catheterization laboratory in Connecticut that offers transcatheter pulmonary valve replacements, including the Melody and Edwards valves. Yale New Haven Children's Hospital's digital pediatric catheterization suite features state-of-the-art equipment that allows for a multidisciplinary approach to patient care. Our team has expertise in nonsurgical transcatheter treatment of aortic and pulmonary valve stenosis, coarctation of the aorta, intravascular stent placement for narrowed arteries and vessels, and blood vessel coil occlusion. Our interventional team also works collaboratively with our pediatric cardiothoracic surgeons to deliver the most innovative hybrid procedures that are intended to minimize surgical time and difficulty, while making patients safer. Through active participation in clinical trials, we continue to push the boundaries of noninvasive treatments to replace pulmonary valves and close atrial septal defects.

At Yale New Haven Children’s Heart Center, we help children feel better. Our goal is to provide safe, sustainable, comprehensive care for pediatric and congenital heart disease across the lifespan. We know that one in every 100 babies will be born with a heart problem, and about a quarter of those will need heart surgery or another intervention within their first year of life. Some will need additional operations as they grow. Children’s heart problems are different from heart disease in adults, and there are many different types. We treat all of them. Our doctors are innovators—many have national and international reputations—and they have access to the latest tools and techniques. They often diagnose heart defects in utero and treat babies soon after they are born, help older children live normal lives, and support teenagers as they transition from pediatric to adult cardiac care. When they aren’t caring for patients, many of our doctors are in the research lab investigating better ways to fix small hearts. We are the only hospital in Connecticut that performs such highly specialized procedures as patent ductus arteriosus (PDA) closures for newborns, allowing many to avoid invasive surgeries, and the only pediatric center in the state to provide heart transplants and mechanical cardiac assist devices. Many of our outcomes surpass the national average in such areas as mortality and length of stay. Yale wants patients to have easy access to care in their communities whenever possible. So, we care for our young patients in Yale New Haven Children’s Hospital and at other locations throughout the state from Greenwich to Old Saybrook.

Pulmonary hypertension is high blood pressure in the arteries of the lungs, which makes the heart work harder and can lead to heart failure. If it is diagnosed properly and quickly, we have effective therapies that can slow the progression of the disease and possibly reverse some of the damage to the lungs and heart. Our doctors have extensive experience dealing with pulmonary hypertension, and we treat adults and children over the age of 12. We are fully committed to defeating pulmonary hypertension and caring for the disease regardless of its cause, which may include pulmonary arterial hypertension (PAH), pulmonary venous hypertension, or chronic thromboembolic pulmonary hypertension, among other causes. We are a national Pulmonary Hypertension Association-accredited Center of Comprehensive Care and Center of Excellence. As the only accredited pulmonary hypertension program in the state, we offer patient- and family-centered care to patients from throughout the Northeast. Our doctors, nurses, coordinators, and researchers are specifically trained and experienced at managing and treating patients with pulmonary hypertension. Patients will have access to other highly skilled specialists, including pulmonologists, cardiologists, rheumatologists, and gastroenterologists. We work closely with members of the Adult Congenital Heart Disease Program, General and Advanced Heart Failure Program, Hereditary Hemorrhagic Telangiectasia Program, and the Liver Transplant Program. We also work in concert with specialists in connective tissue disease such as scleroderma (we are a Scleroderma Center as designated by the Scleroderma Foundation), lupus, Sjogren’s disease, myositis, and dermatomyositis—pulmonary hypertension can be a serious complication of these conditions. Outpatient specialized clinic Designated floors in the hospital for pulmonary hypertension patients State-of-the-art heart catheterization laboratory Highly trained and qualified cardiologists who read echocardiograms focusing on the right side of the heart, which is a key clinical factor in patients with pulmonary hypertension Physicians, nurses, pharmacists, and quality-tested systems in place that provide effective complex therapies to patients in a safe environment.

The Advanced Heart failure Program is a rapidly expanding service at the front lines of treating heart failure. Launched in 1988, the program builds upon decades of experience treating failing hearts. In 2019, we performed 49 heart transplants, putting us among the top centers of the country. Our left ventricular assist device program treats more cases than any other program in the Northeast. It provides heart pumps for patients who need support while they are waiting for a donor heart or who are ineligible for a transplant and need another permanent solution. Heart transplants are the gold standard treatment for patients with end-stage heart failure. But many face a long, difficult wait for a donor heart, and some don’t survive. Yale Medicine is one of a handful of centers in the country to push existing boundaries in heart transplant by aggressively seeking out donor hearts other centers turn down even though they may be suitable for some patients. This process, using what’s called “donation after circulatory death” (DCD) organs, is helping more of our patients get heart transplants sooner. What’s more, our one-year survival rates for heart transplants—93%—are better than the national average. Multi-organ transplants People who live with heart failure have a high likelihood of also having kidney dysfunction from a variety of causes, and this can be a limiting factor in being able to get a heart transplant. For these patients, our heart specialists collaborate with Yale Medicine’s world-class abdominal transplant team and have achieved a robust volume and successful track record in performing heart-kidney transplants. Pioneers in LVAD Yale Medicine helped to pioneer the use of left ventricular assist devices (LVADs), providing patients whose hearts are too weak to function on their own with implantable devices that can pump blood for them. Yale Medicine is one of the leaders in the Northeast in volume and outcomes with LVADs and is certified by the Joint Commission, the nation’s predominant standard-setting and accrediting body in health care. Each one of our patients is treated by a team that includes cardiologists, transplant surgeons, infectious disease specialists, nephrologists, critical care doctors, nurses, pharmacists, social workers, nutritionists, and transplant coordinators, among others. Transplant doctors at Yale are national leaders in the field. Currently, the presidents of United Network for Organ Sharing (UNOS) and the American Society of Transplantation are at Yale, and they have helped to write the guidelines for how to treat patients after solid organ transplants as the field advances. Outcomes above average Patients whose future once seemed difficult have survived for decades after a heart transplant or LVAD implant. The average one-year survival after a Yale Medicine heart transplant is 93%, which is higher than the national average. This is partly due to meticulous follow-up care that includes treatment with immunosu

As our pediatric congenital heart disease patients move from childhood into adulthood, our program is there every step of the way to make sure they receive continuous, comprehensive care for even the most complex heart disease. Our multidisciplinary integrated program was the first in the state dedicated to the care of adult patients with complex congenital heart disease, and encompasses the full spectrum of care, including imaging, exercise testing, and surgical as well as less-invasive catheterization therapies. Our patients can expect to receive detailed information about their underlying congenital heart defect, its management, and the implications on their future heart function. Patients in the program are assured of the careful transition of care from their childhood diagnosis into adulthood, and appropriate wrap-around care for adults who are new to the program. Commonly encountered problems related to adult congenital heart disease (ACHD) include the following: Unrepaired congenital defects Complications associated with early surgical repair Heart failure Heart rhythm problems, including pacemakers and defibrillators Pregnancy issues Our expert, board-certified cardiac physicians and surgeons treat these, among other heart conditions: Atrial septal defect (ASD) Ventricular septal defect (VSD) Atrioventricular canal defect Bicuspid aortic valve Pulmonary stenosis Coarctation of the aorta Ebstein's anomaly Transposition of the great arteries, including those who have had a Mustard or Senning operation or arterial switch operation Congenitally corrected transposition of the great arteries Tetralogy of Fallot Complex single ventricle patients, including those who had a Fontan operation Cyanotic heart disease Patients who had a Ross operation as a child Congenital coronary anomalies, including ALCAPA (anomalous left coronary artery from the pulmonary artery) Instead of delaying treatment for complex congenital heart disease, our state-of-the-art imaging, including echocardiograms (ultrasound) and MRI, allows for early diagnosis, before symptoms may interfere with a patient’s life. Our program also works closely with Yale's maternal-fetal medicine team to care for women with congenital heart disease before and after they give birth. Yale’s world-class congenital cardiac catheterization lab provides access to the latest advances in transcatheter valve placement, treatment of atrial septal defects, and all forms of congenital heart disease. We provide comprehensive electrophysiology services, including management of arrhythmias and placement of pacemakers and defibrillators.