For many patients with significant coronary artery disease, treatment involves medications along with options to improve blood flow to the heart muscle. These options typically include a procedure where a stent is placed, thus clearing the blockage; or a surgery in which blood is rerouted around the blockage(s). But for patients with more complicated coronary artery disease, treatment requires a different type of expertise. The University of Michigan Health Complex Coronary Disease team brings together cardiac surgeons and interventional cardiologists to care for a large volume of complex and high-risk patients with limited treatment options. Often, these patients have been turned down at other health systems. For this diverse, difficult-to-treat population, our specialists provide a wide variety of innovative and advanced treatment options to open up blocked arteries. These range from percutaneous coronary interventions and open surgical procedures to specialized medical management.
Comprehensive Care at the Frankel Cardiovascular Center
The Frankel Cardiovascular Center’s multidisciplinary team develops individualized, evidence-based care strategies for high-risk patients with advanced or complicated coronary artery disease. This includes patients with:
- Blockages that are difficult to treat: totally blocked coronary arteries, heavily calcified blockages and coronary artery side branch blockage (also known as bifurcation blockages)
- Pre-existing conditions: advanced kidney disease, liver disease and/or lung disease
- Additional heart issues: severe valvular disease, blockages in multiple vessels and poor heart function
- Failed stents or previously placed grafts
Our comprehensive team approach is unique. We review all relevant data – including surgical risk and coronary complexity – as a team, and factor in other metrics to help determine the best approach for each individual patient. Working together, our team has the resources and expertise to offer treatment options to a greater number of high-risk patients with outcomes that exceed national averages.
Types of Treatment
Percutaneous Coronary Intervention Our team of interventional cardiologists has expertise in the diagnosis and treatment of patients with severe coronary artery disease, with specialized training in advanced percutaneous coronary intervention (PCI) procedures. PCI is a non-surgical procedure used to treat narrowing of the heart’s coronary arteries. For this advanced, minimally invasive procedure, interventional cardiologists use specialized equipment and techniques to place a small mesh tube called a stent in blocked arteries to widen and support the walls of the arteries and restore normal blood flow. For complex blockages or failed stents we have advanced therapy options:
- Radiation treatment known as brachytherapy
- Blockage removal known as atherectomy
- Laser and lithotripsy treatment of failed stents and heavily calcified arteries
- Stent modification and optimization techniques
Surgical Intervention Our surgical complex coronary intervention team performs advanced procedures tailored to each patient. We perform multi-arterial grafting with both radial artery and bilateral internal mammary artery options. For patients with failed prior bypass surgery we perform a high number of redo-bypass operations. For failed stents we perform an innovative technique known as coronary endarterectomy. The procedure involves removing old stents to re-open the blockage in the coronary artery, which would not be possible without this rare expertise. Our center offers all advanced therapies with expert critical care resources that allow bypass surgery to be offered to high-risk candidates who are turned down at other hospitals. As a heart failure and transplant center of excellence we can also determine if high-risk patients would be better treated with advanced therapies (mechanical pumps or heart transplant) as opposed to bypass surgery. For heart failure patients we can help guide surgical intervention with the goal of improving life expectancy. We have been rated a 3-star program by the Society of Thoracic Surgeons, the highest category of quality, placing U-M Health among the elite for heart bypass surgery.
Your Personalized Care Team
At the Frankel Cardiovascular Center, your complex coronary care team may include:
- Cardiac surgeons
- Interventional cardiologists
- Nurse practitioners and physician assistants
- Surgical team members including anesthesiologists and perfusionists
- Critical care physicians and their team, including respiratory therapists, residents and Extracorporeal Membrane Oxygenation (ECMO) specialists
Our care coordinators help you understand your condition and treatment options. These coordinators communicate with the multidisciplinary team involved in your care and answer your questions.
Make an Appointment
To schedule an evaluation with a Frankel Cardiovascular Center physician, call 888-287-1082. Or visit the Make a Cardiovascular Appointment page to learn what to expect when you call us. Physicians: To refer a patient, call M-Line at 800-962-3555.