Departments

The Robotic Mitral Valve Repair Program started in fall of 2018 and has now performed over 100 operations with 100% repair rates and excellent overall results. Our dedicated robotic cardiac surgery team includes a cardiac surgeon, cardiac surgery physician assistants, cardiac anesthesiologists, perfusionists, and dedicated operative nurses, as well as surgical technicians. The use of a specialized team ensures consistency in approach and outcomes for our patients. Mitral valve prolapse is the most common disease of the mitral valve, affecting 1 to 2% of the population. The leaflets of the valve essentially become floppy, eventually resulting in a “leaky” mitral valve that can cause symptoms of heart failure such as difficulty breathing on exertion, fatigue, and arrhythmias like atrial fibrillation. Robotic mitral valve repair is a treatment generally offered to patients with severe mitral valve regurgitation and mitral valve prolapse. The operation consists of five small incisions on the right side of the chest. The arms of the DaVinci Xi™ robot pass through these small incisions, allowing for a high level of dexterity and precision. Highly specialized tools are used to allow for the least invasive method of performing the surgery. Robotic mitral valve repair is associated with a short hospital stay—patients typically stay in the hospital 2 to 4 days following the surgery, and the majority of patients are back to work within 3 to 4 weeks. It’s also associated with the use of fewer blood products, less pain, fast recovery, superior cosmetic results, and high patient satisfaction. A majority of valves affected by mitral valve prolapse can be repaired by an experienced mitral valve surgeon. Yale is a high-volume mitral valve center that performs over 250 mitral valve procedures each year. Arnar Geirsson, MD, the chief of Cardiac Surgery for Yale Medicine, is a high-volume mitral valve surgeon who performs over 100 mitral valve operations per year, a majority of which are mitral valve repair. Because the repair can be complex, depending on each case, we encourage patients to seek out experienced mitral valve centers and surgeons to ensure that they receive the best results possible. Other conditions requiring repair, such as tricuspid regurgitation, and those requiring ablation (MAZE procedure) such as atrial fibrillation, can be done separately or in conjunction with robotic mitral valve repair. Conditions requiring mitral valve replacement can also often be done with the robotic approach.

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.

Sometimes, an athlete—seemingly in peak physical condition—experiences sudden cardiac arrest on the playing field due to an undiagnosed heart condition. Yale Medicine’s Sports Cardiology Program is dedicated to preventing such tragedies through comprehensive screening, evaluation, and management of cardiovascular disease in athletes. The Sports Cardiology Program brings a multidisciplinary approach to the identification and treatment of potentially life-threatening cardiac abnormalities in athletes. The program provides two distinct services: Pre-participation screening of college and university athletes to detect any potential abnormalities before they compete Consultation and care for athletes of any age who either have known cardiovascular disease or who have symptoms that could be related to cardiovascular disease Yale Medicine specialists begin with an electrocardiogram (ECG), which records the electrical activity of the heart, to check for a variety of cardiac conditions. When screening college and university athletes, Yale experts interpret the ECG, offer recommendations for follow-up care, if needed, and work closely with the school to monitor and advise the athlete going forward. Yale physicians have been performing ECG screenings for Yale University athletes since 2015. With the launch of the Sports Cardiology Program, Yale Medicine is now performing screenings for athletes at three local universities, as well as the Connecticut Whale women’s professional hockey team. In addition to a pre-participation screening of college athletes, the Sports Cardiology Program provides ongoing clinical care for athletes of any age (including children) who have a known cardiac condition or symptoms that may indicate cardiac abnormalities, such as passing out or palpitations. In both cases, the goal is to develop an effective diagnosis, treatment, and management strategy for the athlete and provide recommendations on whether and how the athlete can safely participate in competitive sports. The foundation of Yale Medicine’s program is its multidisciplinary approach to these issues. A team of experts from many specialty areas works together to provide comprehensive, integrated services and holistic care for athletes. The program’s director, Rachel Lampert, MD , is a sports cardiologist, electrophysiologist, and arrhythmia specialist who frequently writes and speaks on preventing sudden cardiac arrest in athletes. Dr. Lampert has conducted extensive research in this area, including studies on whether athletes with implanted defibrillators can safely participate in sports. The Sports Cardiology Program also features imaging teams that use highly specialized diagnostic tools such as cardiac MRIs and echocardiography. The team also includes experts in adult and pediatric arrhythmia, cardiac channelopathies, cardiomyopathy, genetic cardiovascular diseases, and more. In addition, Dr. Lampert and her team frequently partner with Yale’s Sports Medicine Pro

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.

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.

At Yale Medicine, our cardiovascular physicians specialize in all types of heart conditions. Our expert teams focus on heart-related health issues, such as heart disease genetics, heart rhythm problems, heart failure, heart and blood vessel conditions, and heart transplants. Our cardiologists do more than just see patients; they also conduct research to learn more about the complexities of various heart diseases and investigate better ways to treat them. Through their work in five research centers at Yale our cardiologists participate in major research initiatives focused on all aspects of heart health. Our research teams are comprised of experts from all over the world—eight different countries and four continents, to be exact! Specialized care is offered in the following areas: Adult congenital heart disease Arrhythmia Cardiac imaging Cardiomyopathy and congestive heart failure Coronary heart disease General cardiology (including stress tests and holter monitoring) Peripheral vascular heart disease Vascular heart disease

We have a robust history in advancing the practice of cardiovascular catheterization and intervention, and we offer a full spectrum of cardiac care in our state-of-the-art facilities. We care for patients throughout the region at locations throughout Connecticut, and are a national and international referral center for specialty percutaneous interventional procedures, commonly known as angioplasty. Our physicians specialize in complex coronary disease, structural heart disease, and peripheral vascular diseases, and we operate one of the largest carotid artery disease programs in New England. We also have a Comprehensive Coronary Physiology Program that provides care for patients with chest pain that is chronic, unexplained or difficult to manage. Our interventions include: Transradial coronary intervention Coronary chronic total occlusion recanalization and coronary reentry transcatheter aortic valve implantation Intravascular ultrasound and physiologic translesional pressure assessment Rotational atherectomy Thrombectomy Proximal and distal embolic protection Drug eluting stents Advanced hemodynamic support Atrial septal defect, patent foramen ovale, and ventricular septal defect closure Alcohol septal ablation for hypertrophic cardiomyopathy Aortic and mitral valvuloplasty Left main and multivessel percutaneous coronary intervention (PCI) Various peripheral vascular interventions

Our highly skilled cardiologists expertly treat and diagnose heart failure—a chronic, progressive condition in which the heart muscle can’t pump enough blood to meet the body's needs. In addition to caring for cardiac patients at Yale New Haven Hospital, we provide treatment to the rapidly growing number of outpatients living with heart failure in the community. We treat each patient with a personalized plan, carefully monitoring medications on an ongoing basis while minding other issues that affect cardiac health. We also educate patients and their families about lifestyle changes, prescribe and oversee exercise rehabilitation programs, and facilitate communication between the many professionals involved in outpatient care. Our physicians work as part of a multidisciplinary team to offer patients comprehensive care with the goal of prolonging their life and improving its quality. Treatment options may include medications, short- or long-term mechanical support, or heart transplant. Before treatment begins, we perform cardiac diagnostic procedures, such as stress tests, catheterization, and biopsies. We collaborate with cardiac-trained radiologists to provide noninvasive imaging studies including positron emission tomography (PET), computed tomography (CT), magnetic resonance imaging (MRI), and 2D and 3D electrocardiography. At the Center for Advanced Heart Failure at Yale New Haven Hospital, we treat the full continuum of heart failure and offer a variety of medical and surgical treatment options. The center cares for patients with an LVAD (left ventricular assist device), a battery-operated mechanical pump that is surgically implanted and helps maintain the heart’s pumping ability when it can’t work effectively on its own. This is the only long-term mechanical circulatory support for patients otherwise ineligible for heart transplant. Our surgeons regularly perform heart transplants and LVAD implantations, and our heart transplant survival and post-LVAD rates are among the best in the region.

About Us At Yale Medicine, our cardiac surgery team consists of internationally recognized heart surgeons who provide personalized, compassionate care for adult and pediatric patients. We understand the challenges of living with a heart condition and are committed to partnering with patients and their families to find the best treatment plan and offer ongoing support after surgery. Our team includes highly experienced, board-certified cardiac surgeons along with an expert group of cardiologists, cardiac-focused nurses, physician assistants, and nurse practitioners. Our cardiac surgeons collaborate with Yale's cardiologists, vascular surgeons, and internists to manage heart-related issues such as heart failure, coronary artery disease, heart valve conditions, and heart rhythm disorders. Our surgeons perform the latest, most advanced techniques in minimally invasive and traditional surgeries to treat a full range of cardiac diseases and conditions, including: Coronary artery bypass grafting (CABG) Valve repair and replacement (aortic and mitral) Aneurysm repair (aortic, thoracic aortic, left ventricular) Arrhythmia (abnormal heart rhythm), including hybrid ablation heart failure and artificial heart or ventricular assist devices Heart failure, including artificial heart or ventricular assist devices Heart transplantation Congenital heart diseases in children and adults

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

The Preventive Cardiovascular Health Program at Yale (PCHPY) brings a personalized approach to cardiovascular disease prevention. Patients referred to the program meet with one of our cardiologists for an in-depth consultation that takes into account their biology and biography, along with information from advanced diagnostic testing. This approach leads to a more personalized, evidence-based approach to cardiovascular risk assessment. Using this information, and in partnership with patients, we design tailored programs to reduce cardiovascular risk and improve well-being. PCHPY brings together experts in cardiovascular disease prevention, including cardiologists, nutritionists, exercise physiologists and health psychologists. We also work together with Digital Technology Solutions (Information Technology) and digital health companies to offer high-tech/low-burden approaches to cardiovascular care. Our team is highly attuned to the challenges of maintaining a healthy lifestyle and taking medication, and understands that a one-size-fits all approach often falls short. Instead, we strive to understand and integrate each person’ priorities, preferences and goals into the care plan. This program is particularly focused on people who are: At increased risk for cardiovascular disease, including people with: Severe hypercholesterolemia or familial hypercholesterolemia or elevated Lp(a) Family history of premature coronary artery disease (before the age of 60) Poorly controlled hypertension Underlying inflammatory condition (e.g., rheumatoid arthritis, HIV) A diagnosis of ischemic heart disease or coronary artery disease Women with cardiovascular disease Individuals seeking a more personalized approach to cardiovascular health PCHPY additionally works with communities to identify and address barriers to cardiovascular health, focusing on environmental and social factors that contribute to disparities in health outcomes.

Our highly skilled and experienced team specializes in electrophysiology, or the diagnosis and treatment of heart-rhythm abnormalities, also known as arrhythmias. We treat complex arrhythmias and structural heart disease at Yale New Haven Hospital and through several outpatient office locations. At Yale New Haven Hospital, our physicians operate Connecticut’s largest and most comprehensive program for ventricular tachycardia ablation, a procedure that eliminates the heart tissue that causes arrhythmia. Our Complex Ablation Program offers epicardial ablation to treat ventricular tachycardia and atrial fibrillation that originates from the outer surface of the heart. Our operating suites are equipped with cutting-edge technology, including three-dimensional mapping systems, intracardiac ultrasound, and robotics. We offer a full range of device therapies, including pacemakers, defibrillators, and cardiac resynchronization therapy (CRT). We routinely monitor implantable devices using remote technology to ensure patients’ safety, wherever they are. We also offer a clinic in which doctors from electrophysiology and geriatrics work together to manage patients with recurrent falls and syncope, or fainting caused by low blood pressure. Additionally, Yale New Haven Hospital runs the only Atrial Fibrillation Support Group in the state. The group is for all patients and their families and aims to help individuals and their loved ones cope with the psychological and emotional burdens of their disease. For patients at Yale New Haven Hospital, an advanced nurse practitioner dedicated to arrhythmia management is ready to assist, working closely with physicians to ensure a seamless inpatient to outpatient transition.