Know your treatment options for advanced heart failure

Keki Balsara, MD

Keki R. Balsara, MD, MBA, FACS, FACC, is Surgical Director of Heart Transplantation and Mechanical Circulatory Support at the MedStar Heart and Vascular Institute, the highest volume ventricular-assist device program in the Mid Atlantic, and Professor of Surgery at Georgetown University School of Medicine.

Dr. Balsara joins us from the Vanderbilt University Medical Center, where he served as Associate Professor of Surgery and Chief Quality and Safety Officer in the Department of Cardiac Surgery. Moreover, he was the Vice Chair of Network Surgical Strategy and Development for the Section of Surgical Sciences. He had an additional appointment at the Tennessee Valley Healthcare System. He was previously Assistant Professor of Surgery in the Division of Cardiothoracic Surgery and Surgical Director for the Cardiothoracic Surgery ICU at Washington University in St. Louis/Barnes Jewish Hospital.

As a board-certified cardiac surgeon and intensivist with nearly 10 years of experience in the field, Dr. Balsara sees patients across the entire spectrum of cardiac disease. This includes coronary artery disease, valvular heart disease, aortic pathology, and complex re-operative surgery. He has a particular interest in end-stage heart failure, heart transplantation, and mechanical circulatory support. He brings with him a wealth of experience in expanding both the donor and recipient pools for transplantation, including the use of hepatitis-C and DCD-donors, as well as broad utilization of the TransMedics® OCS™ Heart System platform and normothermic regional perfusion.

Additional clinical interests include cardiac critical care and end-of-life care. Dr. Balsara has a particular interest in quality improvement and standardization of care to improve outcomes, reduce waste, and increase access to care. In particular, he is passionate about leveraging the scale of health systems to offer a variety of cutting-edge therapies to patients from varied geographic and economic backgrounds who have previously been denied access.

His research interests have focused on expanding ways to increase the number of organs available, including the use of the TransMedics® OCS™ Heart System, identifying DCD (donor after cardiac death) donors, and the use of normothermic regional perfusion (NRP) for DCD donor organs. More recently, his research has looked at maximizing hospital-wide efficiencies, focusing on cost-containment in the operating room, an interest that goes hand-in-hand with his MBA focus on management and strategy.

Dr. Balsara received his undergraduate and medical degrees from the University of Pennsylvania. He holds a Master of Business Administration from the Wharton School at the University of Pennsylvania. He completed an internship and residency in general surgery at the Duke University School of Medicine. In addition, he completed a post-doctoral research fellowship in end-stage heart and lung failure and a fellowship in surgical critical care at Duke. He did his cardiothoracic surgical training at the Johns Hopkins Hospital.

Dedicated to the advancement of the field of cardiothoracic surgery, Dr. Balsara is widely published and has authored more than 50 peer-reviewed articles and multiple book chapters, and has been an invited lecturer, discussant, and/or moderator for numerous national and international meetings. He is also committed to teaching medical students and residents, cultivating the next generation of healthcare leaders.

He is a member of the International Society for Heart and Lung Transplantation, American College of Surgeons, Society of Thoracic Surgeons, Southern Thoracic Surgical Association, American Heart Association, American College of Cardiology, and American College of Healthcare Executives.

Dr. Balsara is an Ad Hoc reviewer for multiple publications, including Allergy – The European Journal of Allergy and Immunology, Journal of Thoracic and Cardiovascular Surgery, Annals of Thoracic Surgery, Journal of Heart Failure, Artificial Organ Research and Development ASAIO Journal.

Philosophy of Care:
“All too often people think of surgeons as the doctors who just show up to the operating room when, in fact, I think performing surgery is but one of our tasks. Yes, I am a surgeon. But fundamentally, my job is to provide the appropriate guidance, counsel, and support to help my patients understand their diagnosis, treatment options, and prognosis so that, together, we can choose what’s best for them and their families.

“There’s no one size fits all approach to what we do. In order to make the best treatment recommendations, I take the time to get to know my patients, listen to their treatment goals, and answer all of their questions. My goal for each patient is to provide the best quality of life for the longest time possible. Ultimately, I’m guided and motivated to do what’s in each person’s best interest.

“I’m honest and straightforward with my patients. I owe them that. I have been on the receiving end of difficult healthcare conversations and, therefore, I firmly believe in honesty and transparency. The only way that my patients can make the best treatment decisions for themselves is to have a realistic idea of their situation, as terrifying as it may feel."