Cardiovascular Center: Guide To Services

Cardiovascular disease – involving disorders of the heart, blood vessels and circulatory system – affects more than 70 million Americans. Heart disease alone is the leading cause of death for both men and women. The Brigham and Women’s Hospital Cardiovascular Center is dedicated to delivering advanced, innovative, multidisciplinary and compassionate care to our patients with cardiovascular disorders. Combining our latest research and state-of-the art technology, along with the body of knowledge our experts have developed over the past century, we are committed to providing specialized care tailored to the needs of each patient.  Our Cardiovascular Center is one of the largest programs of its kind in the world and our specialists work as a team to integrate their knowledge and expertise to provide each patient with an individualized treatment plan.

Patients come to our Center through referral from their primary care physician or cardiologist and through our Emergency Room, where we have a special cardiac evaluation unit to fast track diagnosis and treatment. Often physicians refer, or patients self-refer, seeking a second opinion on cardiac conditions.

As a major teaching hospital of Harvard Medical School, we are dedicated not only to superb patient care, but also to biomedical research and training the next generation of cardiovascular experts.

Call 1-800-BWH-9999 if you would like to make an appointment with one of our Cardiovascular Center experts or receive more information. Visit us at www.brighamandwomens.org/cvcenter to take a virtual tour or to learn more.

Evaluation and Diagnosis

Our Cardiovascular Center offers comprehensive treatment plans for all cardiovascular disorders including:

• Heart failure
• Cardiac arrhythmia
• Valve disease
• Coronary and peripheral artery disease
• Lipid and metabolic disorders
• Cardiovascular genetic disorders

The foundation of exceptional cardiovascular care is an excellent diagnosis. Brigham and Women’s Hospital has a comprehensive diagnostic arsenal, including newer, non-invasive imaging tests. For each diagnostic test, our Cardiovascular Center has a team of experts who interpret the study in consultation with sub-specialists in the relevant disease areas to develop the most precise diagnosis – and ultimately treatment plan – possible. 

Standard Tests

Standard diagnostic cardiac tests include:

• C-reactive protein testing
• Electrocardiogram
• Exercise stress test
• Fasting lipid profile
• Transesophageal echocardiogram
• Transthoracic echocardiogram
• Event and holter monitors

Also, our specialized Vascular Laboratory offers non-invasive studies and in-depth evaluation of central and peripheral arterial and venous disorders. (For more information, refer to “Vascular and Endovascular Surgery”)

Cardiovascular Imaging

The Cardiovascular Imaging Service at Brigham and Women’s Hospital offers advanced evaluation of patients with cardiovascular disease through the latest CT and MR technology – coupled with staff specifically trained to use this next generation equipment – to provide the most comprehensive evaluation of cardiac and vascular conditions. This new generation of scanning technology has had a major impact on improving cardiovascular diagnostic care.

We offer a full range of advanced cardiac CT and MRI applications, including:

• Multi-detector CT Angiography: One of the newest CT applications, this test uses x-rays and a contrast dye to create three-dimensional images that can identify coronary artery and vascular diseases. It is less invasive than traditional catheter angiography.
• Magnetic Resonance Imaging (MRI): This test uses high-intensity magnetic fields to provide images of soft tissues that ordinary x-rays cannot, and is useful for detecting thickness in the cardiac walls, congenital defects, and to evaluate cardiac viability after a heart attack.  

In addition to CT and MRI, the Cardiovascular Center offers patients and their referring physicians a full battery of nuclear cardiology studies, all of which are performed and interpreted by sub-specialty experts. These include:

• Positron Emission Tomography/Computed Tomography (PET-CT): PET-CT combines the superior imaging of PET with the precise anatomic assessment of CT scanning. With PET-CT, physicians can evaluate blood flow to the heart at rest and during cardiac stress followed by non-invasive CT coronary angiography. This provides a measure of the anatomic and functional severity of coronary artery disease.
• SPECT Myocardial Perfusion Scan: Also called a cardiac stress-rest test, this test evaluates the heart muscle’s blood supply at rest and during exercise stress.

Advances in non-invasive nuclear imaging, many pioneered at Brigham and Women’s Hospital, are allowing for a faster, more comfortable and precise diagnosis. The Service also offers a full range of non-invasive vascular imaging services, using CT and MR technology, for the evaluation of the thoracic and abdominal aorta, carotid disease, peripheral vascular disease and other vascular conditions. (For more information, refer to “Vascular and Endovascular Surgery”)

Our Center is known throughout the region, the country and the world for our ability to diagnose and treat patients who have been referred because their condition was deemed untreatable or too complex for other hospitals.

Innovations in Cardiovascular Imaging Research

The Cardiovascular Imaging Service is involved in many research initiatives to advance the evaluation of cardiovascular disease, including:

• New use of stress imaging;
• Using physiologic imaging to study blood flow in the heart and arteries;
• Characterization of atherosclerotic plaque in the carotid and peripheral arteries using external and intravascular detector coils;
• New contrast agents for MR imaging;
• Accuracy of coronary CTA.

Cardiovascular Genetics Center

Many cardiovascular disorders are caused by inherited gene mutations. In recent years researchers have made significant discoveries into the molecular mechanisms that underlie a number of important genetic cardiovascular disorders. This new information is helping to redefine our understanding of heart failure and risk for sudden cardiac death.  Unraveling the molecular and genetic basis for cardiovascular disease and then applying this knowledge to improve patient care defines the next era of medicine.

The Cardiovascular Genetics Center provides comprehensive, innovative evaluation, diagnosis, and management of individuals and families with inherited cardiac disorders, including:

• Hypertrophic cardiomyopathy (HCM)
• Familial dilated cardiomyopathy (DCM)
• Inherited arrhythmias
• Inherited aortic aneurysms
• Marfan Syndrome

At the Cardiovascular Genetics Center, our multidisciplinary team is composed of nationally recognized physicians and scientists working at this interface between discoveries in the basic science laboratory and clinical medicine. We are dedicated to the advancement of our understanding and treatment of inherited cardiovascular disease.

Clinical Cardiology

Clinical cardiology is the backbone of cardiovascular care. Our specialists are most often the first cardiovascular physicians to see patients in the emergency room, the Coronary Care Unit, or those referred for office consultation. We work closely with the Cardiac Surgery Service in the evaluation and management of patients with valvular heart disease and coronary artery disease.

Our Cardiovascular Center experts determine and coordinate:

• Diagnostic testing;
• Cardiac sub-specialty or surgical referral when appropriate;
• Comprehensive treatment plans including medications, lifestyle changes, and interventional or surgical therapy;
• Close working relationship with the patient’s referring physician.

Prevention

Our prevention program identifies and treats patients who have disorders that contribute to cardiovascular disease. Physicians, counselors, and dietitians are available to manage patients with combinations of risk factors such as hypertension, dyslipidemia, and diabetes. We also coordinate smoking cessation, diet and exercise programs to help patients reduce their risk for cardiovascular disease.

Vascular Medicine

Our team includes specialists in vascular medicine, who are available to evaluate and manage patients with arterial and venous disease. They contribute on a continuing basis to treatment of coexistent cardiac disease, hypertension, diabetes, and lipid and thrombotic disorders.

Center for Cardiovascular Disease in Women

Our Center for Cardiovascular Disease in Women builds on our strong foundation in clinical cardiology to develop a unique practice that provides gender-specific care to women diagnosed with heart disease or with risk factors for heart disease. Many people do not realize that more women than men die each year from cardiovascular disease. In fact, heart disease is responsible for 52 percent of all deaths in American women, claiming a quarter of a million women’s lives every year – more than all forms of cancer.

At the Center, we:

• Assess and treat women with known coronary artery disease;
• Assess and educate women about their risk factors for cardiovascular disease;
• Have a comprehensive diagnostic evaluation, risk factor management and treatment program specially tailored to the gender-specific needs of women;
• Have an extensive education and outreach component, to help women prevent cardiovascular disease, and to identify and address symptoms and risk factors as early as possible;
• Provide a coordinated continuum of care for all
• cardiovascular services a woman may need.

Setting the Standards in Care

Because so many of our clinical cardiologists are involved in translational and clinical research, we are developing new guidelines and testing the latest therapies. Our cardiologists have set the standards used around the world for treatment in patients with heart disease, including:

• Cholesterol levels
• C-reactive protein testing
• Use of ACE inhibitors and beta blockers
• Use of clot-busting drugs

Interventional Cardiology

The Cardiac Catheterization Laboratory at the Brigham and Women’s Hospital Cardiovascular Center is one of the busiest and most respected catheterization laboratories in the country, performing approximately 7,000 total procedures and 2,500 therapeutic interventional procedures each year.

Diagnostic Catheterization

We offer a comprehensive range of diagnostic and therapeutic vascular and cardiac services using catheters to:

• Measure the blood flow and internal pressures of the heart;
• Assess heart valve leakage or blockage;
• With angiography, examine the insides of the arteries throughout the body for blockages.
• Interventional Cardiology Treatment

Interventional cardiology refers to a number of non-surgical procedures for treating cardiovascular disease. These include:

• Angioplasty and Stenting: With this treatment, a special balloon at the end of a catheter is threaded up to the site of arterial blockage, inflated to compress the atherosclerotic plaque, and thus increase blood flow in the coronary arteries or other arteries supplying the legs, arms, kidneys, and brain. In most cases, a small metal mesh cylinder called a stent is then placed in the vessel to keep it open.
• Drug-eluting Stents: In the past few years, newly developed drug-eluting stents (that release medication to prevent scarring and restenosis) have revolutionized the field of interventional cardiology. Physicians at the Brigham and Women’s Hospital Cardiovascular Center were pioneers in the development of drug-eluting stents and used them in clinical trials long before the U.S. Food and Drug Administration approved them. Coated drug-eluting stent technology has increased the long-term success of coronary stenting by dramatically reducing the rate of restenosis to less than five percent, and has become the standard of care for most coronary stent patients. 
• Cartoid Stents: In certain patients with narrowed carotid arteries, collaboratively working with our colleagues in vascular and endovascular surgery, carotid stenting is performed to preserve or restore proper blood flow to the brain. In those with leg pain and cramps caused by limited blood flow, stenting can often restore flow and avoid the need for open surgery. Patients with high blood pressure or kidney abnormalities related to narrowing of the renal arteries can often be treated with stents, limiting their need for medication and protecting their kidney function.

Cutting-edge Interventional Cardiology Research

Members of the Brigham and Women’s Hospital Cardiac Catheterization Laboratory have played a central role in developing new, cutting-edge interventional cardiology treatments. We have led national and international clinical trials evaluating:

• New technologies in stents
• Devices that treat total occlusion or complex blockages of the arteries
• Treatment of diseased bypass vein grafts

Our Laboratory is a national leader in the emerging field of percutaneous or catheter-based mitral valve repair and repairing abnormal connections between heart chambers. Access to new technologies in these realms, unique in the northeast, greatly broadens our offerings to patients.

Cardiac Arrhythmia Service

The Cardiac Arrhythmia Service performs over 2,000 procedures every year and has grown into one of the most experienced laboratories in the country. The Service has become the “go to” resource within the field of arrhythmia research and care. We are dedicated to providing comprehensive, compassionate, and cost-effective care for patients with cardiac arrhythmias, which are irregular or abnormal heartbeats.

Our Service treats all types of cardiac arrhythmias.

• Atrial Fibrillation (AF): The most common type of arrhythmia, AF occurs when the upper chambers of the heart quiver rapidly and irregularly due to chaotic electrical activity. AF is typically not life threatening but it can compromise the quality-of-life.
• Bradychardia: An abnormally slow heartbeat that can lead to symptoms such as fatigue, shortness-of-breath or passing out.
• Tachycardia: An unusually fast heartbeat. It is most often due to an electrical short circuit in the heart. Some of these arrhythmias are highly symptomatic but not life threatening, while others are responsible for the leading cause of death in this country, sudden cardiac death (SCD).

Diagnosis

In addition to the standard diagnostic tools such as electrocardiograms, echocardiograms, and ambulatory monitoring, advanced cardiac imaging and electrophysiology studies are especially valuable tools for diagnosing cardiac arrhythmias, enabling electrophysiologists to study the electrical signals of the heart, identify heart rhythm disturbances, and locate areas that are causing the disturbance.

Treatment

The Cardiac Arrhythmia Service is a world leader in the treatment of cardiac arrhythmias and is committed to providing its patients with the latest medications, devices, and interventions available.

• Catheter Ablation: Many cardiac arrhythmias are now curable. Catheter ablation is a minimally invasive procedure during which catheters are inserted through the blood vessels in the upper leg and advanced into the heart, delivering energy to the abnormal areas of the heart eliminating the source of the arrhythmia.
• Pacemakers/ICDs: Some types of cardiac arrhythmias can be treated with an implantable device, such as a pacemaker or an implantable cardioverter-defibrillator called an ICD. A standard pacemaker sends an electrical impulse to the heart to restore normal rhythm. ICDs can function as a pacemaker and deliver a shock to the heart when needed to restore it to a normal rhythm.
• Lead Extraction: ICD and pacemaker leads, the wires that carry signals from the device to the heart, get scarred in place over time and can malfunction.
• We are one of the few centers that, using laser energy, can perform even the most complex lead extractions. 
• Cardiac Resynchronization: Many patients with heart failure suffer from cardiac arrhythmias. In close collaboration with our Advanced Heart Disease Program, we can provide comprehensive care for these patients. Devices, such as, biventricular pacing for cardiac resynchronization therapy are exciting new therapeutic options.

Leading the Way in Arrhythmia Research

The Electrophysiology team is on the cutting edge of arrhythmia research. This includes clinical trials testing new pacing devices and procedures, advanced mapping technology, image guided therapy, and even the potential for completely non-invasive ablation. These breakthroughs will be available to our patients at the Arrhythmia Service of Brigham and Women’s Hospital.

Advanced Heart Disease Program

The Advanced Heart Disease Program treats patients with all types of heart muscle abnormalities and heart failure with the goal of not only prolonging life, but also improving the quality-of-life. New innovative treatment approaches by Cardiovascular Center faculty are preventing many patients with advanced heart disease from ever needing heart transplantation.

• Evaluation: Our Program begins with a careful assessment by specialized cardiologists and nurses. We have the capability to visualize the heart muscle, evaluate its pumping action, and detect thickness of the cardiac walls with a full range of non-invasive tests.
• Medical Therapies: We offer intravenous therapies tailored to the relief of each patient’s symptoms and can resolve excess fluid build-up using these intravenous medications or a special venous filtration system. During the hospital stay we develop an individualized oral medication regimen that the patient can use at home. 
• Cardiac Resynchronization Therapy (CRT): CRT involves the use of a unique type of cardiac pacemaker, inserted by our Cardiac Arrhythmia Service, to overcome the delay in the heart’s electrical conduction and restore normal pumping for patients with heart failure who also have an abnormality in the heart’s electrical system resulting in an uncoordinated contraction pattern of the heart muscle. Studies of CRT involving more than 2,000 patients worldwide have consistently demonstrated improvements in exercise tolerance, severity of heart failure, and quality-of-life in most patients.
• Cardiac Surgery: Our team offers a number of options for patients including bypass, valve repair, and ventricular reconstruction. We perform heart transplants for patients who fail all other medical, device, or surgical options and who are appropriate candidates. The Cardiovascular Center at Brigham and Women’s Hospital has done more heart transplants than any other program in the region. (For more information, refer to “Cardiac Surgery”)
• Left Ventricular Assist Device (LVAD) Destination Therapy: Our Program is one of a handful across the country to offer LVAD, an implanted device that assists in the proper functioning of the heart – enabling patients to resume most normal activities. Brigham and Women’s Hospital was the first site in New England for the landmark REMATCH trial, which compared outcomes for patients managed with LVAD plus medical therapy with outcomes for patients on optimal medical therapy alone. The trial demonstrated a better survival rate among the LVAD group.
• Heart Transplantation: We were the first in New England to perform a heart transplant and have done more than any other center in New England – more than 500 since 1984.

Pioneering Research in Advanced Heart Disease

The Advanced Heart Disease Program offers a variety of clinical trials for patients, pioneering a number of efforts including:

• Implantable hemodynamic monitors that allow patients to transmit cardiac information from home to physicians for adjustment of therapies;
• New therapies to improve kidney function in the setting of heart disease;
• Intermittent outpatient infusions of vasoactive medications;
• Percutaneous mitral valve repair;
• Cell therapy to repair injured heart tissue.

Vascular and Endovascular Surgery

The care of patients with peripheral vascular disease has undergone dramatic changes over the past several years. Recent advances in endovascular techniques, minimally invasive open surgery and exciting research have dramatically broadened the options for care.  As a regional, national and international referral center, the Cardiovascular Center has broad experience in managing vascular conditions ranging from the most common to the rare and complex, including:

• Aortic Aneurysms: These are enlargements of arteries caused by a progressive weakening of the arterial wall. One of the most common sites for aneurysm formation is the abdominal aorta. There are two major techniques for the repair of aortic aneurysms. The traditional open surgical operation replaces the diseased segment of the aorta with a strong and durable artificial graft that is sewn in its place. More recently, newer catheter-based technologies have been developed for minimally invasive treatment of aortic aneurysms.
• Carotid Occlusive Disease: When atherosclerosis (hardening of the arteries) builds up in the carotid artery, blood flow to the brain may be impaired, increasing the patient’s risk of stroke. Carotid endarterectomy, the primary option for treatment, is an open surgical technique to remove the atherosclerotic plaque from the inside of the carotid artery. Carotid angioplasty, performed on select patients (depending on their age, co-morbidity, anatomy and preference), is another treatment option that was FDA-approved in August 2004 for patients with who are at increased risk of complications from the open procedure. Stent-assisted carotid angioplasty is performed percutaneously through a catheter in the femoral (groin) artery.
• Peripheral Artery Occlusive Disease: This disease is an extremely common and serious problem affecting more than 20 percent of patients over 70 years of age. Peripheral arterial disease generally results from atherosclerosis leading to impaired circulation to the extremities and other vital organs. Whenever applicable, patients are treated with less invasive balloon angioplasty of the blocked vessels, with or without arterial stent placement. In cases where the blockages are too diffuse or severe, open surgical bypass operations are performed to restore circulation.
• Renal Artery Stenosis: Atherosclerosis may affect and impair blood flow to the kidneys. This may result in impaired kidney function as well as progressive and severe high blood pressure. The majority of patients who require intervention can be treated with minimally invasive catheter-based balloon stent angioplasty through the femoral arteries.
• Venous Disease: Venous disease takes many forms ranging from cosmetically displeasing spider veins to painful varicose veins to severe venous insufficiency with skin ulceration. Traditional surgical methods are used to treat large varicose veins.

Leading-edge Vascular Research

Our experts are involved in an exciting and active research program, exploring innovations such as:

• Development of new endovascular procedures;
• Drug treatment of vein grafts to prevent restenosis;
• New devices for the treatment of thoracic and abdominal aortic aneurysms;
• Assessment of outcomes following surgical treatment of aneurysms, lower extremity occlusive disease, and carotid disease to help define standards of care.

We also have an active basic science research program focused on bringing innovations to the care of patients with peripheral vascular disease. These and other advances guarantee that we will continue to bring our patients the latest technologies in vascular and endovascular surgery.

Cardiac Surgery

The Cardiovascular Center at Brigham and Women’s Hospital has been pioneering advances in the cardiac surgery field since 1923, when cardiac surgeons at that time performed the world’s first successful heart valve operation. We treat the full range of acquired and congenital diseases of the heart and vascular system in adult patients. During recent years, our surgeons have sought to decrease the trauma of heart surgery by developing and adopting minimally invasive methods to decrease pain, complications, and recovery time, while achieving superior results.

We perform:

• Coronary Artery Bypass Surgery: Coronary artery bypass is the most common form of cardiac surgery. Since 1970, more than 15,000 patients have undergone coronary bypass surgery at the Brigham and Women’s Hospital Cardiovascular Center. Advanced techniques in coronary revascularization are performed including minimally invasive coronary bypass surgery with robotic assistance, reoperative coronary bypass techniques, and off-pump coronary bypass.
• Cardiac Valve Surgery: The Brigham Cardiac Valve Center is a world-renowned referral center for reparative and replacement valve operations. The program includes an ongoing emphasis on valve repair, both minimally invasively and through conventional incisions. Our surgeons pioneered minimally invasive valve procedures in 1996 and have done 1,400 cases – increasing every year as more patients and their physicians seek this less traumatic surgery. Selective mitral valve patients have been operated upon using the da Vinci robotics system.
• Thoracic Aortic Aneurysm Surgery: For the treatment of thoracic aortic disease, our program provides diagnosis and care of patients with ascending, arch, descending, and thoracoabdominal aortic aneurysms or dissections. Our collaboration with vascular surgery colleagues has resulted in new protocols for the use of endovascular thoracic aortic stent graft procedures.
• Heart Failure Transplantation and Mechanical Assistance: We offer the most advanced treatment options for heart failure including ventricular circulatory support devices, surgical ventricular remodeling, mitral valve reconstruction for high-risk cardiomyopathy patients and heart transplantation.
• Arrhythmia Surgery: Performed in conjunction with our electrophysiology colleagues in the Cardiac Arrhythmia Service, we provide state-of-the art clinical and investigational therapy for patients with complex atrial and ventricular arrhythmias. Surgical procedures incorporate the latest technologies including cryotherapy, radiofrequency, and laser ablation probes.

Innovative Hybrid Procedures

In the future, many cardiac operations will be performed as hybrid procedures using a combination of cardiac surgery and interventional cardiology in the same OR. Hybrid procedures combine catheter-based coronary revascularization using stents with minimally invasive surgical valve repair or replacement. This allows patients with multiple cardiovascular conditions to receive simultaneous treatment, streamlining procedures and reducing recovery time.

Hybrid procedures have already begun at the Cardiovascular Center at Brigham and Women’s Hospital. To facilitate these procedures, the Cardiovascular Center is developing a macro interventional “OR of the future” that will combine both interventional and surgical procedures using this new hybrid approach.

Innovation and the Future

Our Cardiovascular Center has a long history of advancing the field, ranging from basic science discoveries through the development of new tests and guidelines to pioneering applications of surgical techniques.

We are fortunate to now stand on the threshold of a new era in cardiovascular care. Molecular and genetic approaches will allow us to probe deeply cellular functions at levels unimagined a few short years ago. New imaging methods are evolving that will visualize the functions of the heart and blood vessels with unprecedented clarity.

Members of our research staff include world leaders in basic research in heart and vascular biology. As examples, we have advanced the understanding of:

• The genetic basis of disorders of the heart muscle;
• The use of stem cells in regeneration of heart tissue;
• The pathogenesis of atherosclerosis;
• The causes of inflammation in arteries.

Members of our cardiovascular medicine staff have led the way in population studies of risk factors and therapies for cardiovascular diseases. Most notably, our researchers have transformed contemporary cardiology by demonstrating that inflammatory markers can predict cardiovascular events, high blood pressure and diabetes. 

Brigham and Women’s Hospital is world-renowned for large-scale randomized clinical trials. These include studies that emanate from the TIMI (Thrombolysis in Myocardial Infarction) series. The pioneering findings with respect to the use of “clot-busting” drugs and blood-thinning drugs in patients with unstable angina, heart attack and coronary artery disease have reduced by 40 percent the number of people who die from cardiac arrest, and have driven changes in medical practice worldwide.

Our cardiovascular specialists have made many important contributions to the development of new therapies. Examples include:

• Therapies for cardiac rhythm disturbances;
• Pre-clinical studies of coronary stents;
• New techniques to repair heart valves;
• Improve cardiac revascularization and performance;
• Mechanical circulatory assistance and support to patients awaiting heart transplantation;
• Limb salvage techniques for peripheral vascular disease;
• Intraoperative gene therapy for vein grafts.

Coming in 2008: New Home for Cardiovascular Center

Thanks to the generous donation of Carl and Ruth Shapiro, we are able to continue our quest to provide the most advanced and comprehensive cardiovascular care. Our new Ruth and Carl Shapiro Cardiovascular Center will be located across the street and connected by a bridge to our main campus.

By thoughtfully locating related services in a single building dedicated to cardiovascular care, patients will receive the most advanced and informed care in the country by a team of outstanding medical experts devoted to their needs. The Carl and Ruth Shapiro Cardiovascular Center is being planned today for tomorrow’s cardiovascular care.

Cardiovascular Center Milestones

1923    First successful valve surgery in the world

1944    First in the world to perform catheterization of the right heart and pulmonary artery

1951    First calculation of heart valve areas and thereby establishing precise indications for the surgical correction of valvular diseases

1959    First successful ball valve aortic valve replacement

1960    First successful arterial counter pulsation device

1962    First in the United States to use electric current to restore normal heart rhythm

1972    First to use porcine heterograft and homograft valves to replace diseased heart valves in New England

1979    First introduced the technique of femoral catheterizatoin using an arterial sheath, now standard worldwide

1980    First to give antibodies to treat digoxin toxicity

1984    First heart transplant in New England

1984    Researchers launch TIMI trials, which demonstrate that new clot-busting drugs can save heart muscle and improve patients’ chances of surviving a heart attack. The series of 24 trials has revolutionized the care of heart-attack patients

1986    First described endothelial dysfunction in coronary artery disease.

1989    First to map the gene for familial hypertrophic cardiomyopathy

1991    First implant of a left ventricular assist device (LVAD) in New England

1992    First to identify a gene responsible for a severe, early-onset form of hypertension which runs in families

1992    First heart-lung transplant in Massachusetts

1993    First in New England to use transmyocardial laser revascularization

1999    First intraoperative gene therapy of vein grafts in the world

1999    First implant of a left ventricular assist device (LVAD) as permanent (destination) therapy for end-stage heart failure

2000    First hospital in New England to use a filter during stenting to prevent heart disease

2001    First pharmacological stress cardiac MRI program in New England to combine assessment of myocardial function, perfusion, and viability in patients suspected to have coronary artery disease

2004     National guidelines on cholesterol changed based on BWH discoveries

2004    First in the U.S. to use hybrid PET/CT imaging for combined imaging of cardiac blood flow and coronary anatomy

2004    One of the first Centers to use a 64-row multi-detector CT to image the coronary arteries non-invasively

2004    First to apply time-resolved MR angiography for evaluating patients with vascular diseases, and for electrophysiology ablation planning

2005    First in New England to correct mitral valve function non-surgically