As cardiologists, naturally the physicians at HeartWell are accustomed to seeing patients with various heart issues. But no two patients are exactly alike – and therefore, no two treatment programs are identical.
HeartWell has established a CHIP program – Complete revascularization for High-risk Indicated Patients – that identifies patients who are at high risk for revascularization of their coronary artery blockages and work to establish a personalized treatment program to help by other means.
“We see patients that may have already had surgery, and can’t handle another one, or may be too frail to sustain a surgical procedure due to their low ejection fraction, so our goal is to work as a team in a multidisciplinary approach with other cardiac specialists to formulate the right protocol for these patients,” said Dr. Ramon Lloret, who is spearheading the CHIP program.
Lloret says that he, as an interventional cardiologist, consults with other doctors such as cardiovascular surgeons, heart failure specialists, clinical cardiologists and electrophysiologists to review patient records and provide advice and counsel on the best option.
He notes that there are many issues that make patients a high surgical risk. Co-morbid illnesses such as diabetes, mitral valve regurgitation, severe hypertension or renal insufficiency make surgery a less viable option. Patients who have a low-ejection fraction or active heart failure as well as complex coronary anatomy including chronic total occlusion or left main disease are also considered at the highest risk. Patients with advanced age and frailty are additional factors that would reduce the likelihood a surgeon would operate.
In these cases, Dr. Lloret says that the interventional cardiologist re-vascularizes the patient percutaneously, using balloons, stents, rotablational atherectomy, or possible laser with the aid of hemodynamic support when necessary. Hemodynamic support for a failing heart or mechanical circulatory support (MCS) can come in the form of an intra-aortic balloon pump, or percutaneous, ventricular assist device such as an Impella, Tandem Heart or extracorporeal membrane oxygenation (ECMO). The Team of interventionalist cardiologists includes Ramon L. Lloret, M.D., Ramon Quesada, M.D., Marcus St. John, M.D., Bernardo Lopez-Sanabria, M.D., and Alvaro Gomez, M.D.
“We have developed several other options for these high-risk indicated patients, including hybrid procedures that combine treatments for excellent outcomes,” added Dr. Lloret. He notes that there are many prescription medications that can also be very effective.
HeartWell cardiologists offer a wide-range of customized treatment plans for their cardiac patients. The establishment of the CHIP program formalizes the process and provides patients with a better understanding of how their particular heart issues will be tackled.
About HeartWell, LLP
HeartWell, LLP is a medical practice consisting of 26 cardiologists in ten South Florida offices , with a concentration in the Kendall/Coral Gables area. Every HeartWell patient receives an accurate, thorough evaluation and diagnosis followed up by the most advanced solutions available to appropriately manage cardiovascular diseases through the timely application of lifestyle changes, medical therapies and interventional technologies.
HeartWell’s physicians are among the most skilled and respected doctors in the area who all provide personalized care—including education about preventive measures—for patients who have, or are at risk for, cardiac and vascular diseases. Office-based services include arrhythmia management, hyperlipidemia management, coronary disease management, smoking cessation, cardiovascular research; diagnostics such as carotid ultrasound studies, nuclear stress tests, echocardiography; and hospital/outpatient services including cardiac catheterization, TAVR, interventional cardiology, catheter ablation for atrial fibrillation and implantation of pacemakers and defibrillators.
For more information, visit www.HeartWell.com