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COMPLEX CORONARY Disease
Complex coronary disease specialists at the Frankel CVC have expertise in advanced treatments, ranging from open surgical and percutaneous revascularization to specialized medical management. We care for a large volume of high-risk and complex patients who have limited treatment options and many of whom have been declined at other treatment centers.
A dedicated heart team of cardiac surgeons, interventional cardiologists, and critical care specialists collaborate in multidisciplinary conferences to develop individualized, evidencebased treatment plans to optimize outcomes for patients with mutli-vessel disease.
CORONARY DIAGNOSTICS
Routine use of coronary physiology to guide treatment decisions.
The latest coronary flow technology to evaluate patients with microvascular dysfunction, an underrecognized diagnosis that often affects patients with significant exertional symptoms who do not have major large-vessel coronary disease.
CATHETER-BASED OPTIONS
A high percentage of our percutaneous coronary intervention (PCI) patients have one or more highly complex coronary lesion features, including left main coronary artery location, in-stent restenosis, and significant calcification.
NEARLY 1/2 OF THE PCIs performed in FY24 WERE CONSIDERED COMPLEX
We are one of few institutions in the state with access to coronary drug-coated balloons, a new treatment option recently approved by the FDA for patients who have recurrent blockages or blockages within previously placed stents. These allow physicians to simultaneously treat coronary lesions and deliver medication to the blood vessel wall to prevent recurrence.
• As one of the few teams in the state with expertise in the catheter-based treatment of chronic total occlusions (CTO), we offer advanced, clinically proven, minimally invasive solutions to improve quality of life for patients with chronic angina or cardiac dysfunction.
TOP SUCCESS AND SAFETY RATES in Complex and CTO Interventions
For patients with in-stent restenosis or stent failure, our interventional cardiologists offer optimization techniques including coronary brachytherapy. By directing radiation inside the affected vessel our team can remediate the stent and prevent recurrent stent failure.
Nearly ¼ of patients undergoing stent placement at U-M Health in 2023 underwent vessel preparation with advanced calcium modification therapies
Older patients with coronary disease are more likely to have significant calcification not amenable to conventional angioplasty balloons and stent placement. We offer minimally invasive treatment options that remove obstructive calcium to obtain optimal outcomes, including atherectomy and intravascular lithotripsy
SURGICAL OPTIONS
Exceptional expertise in multi-arterial grafting
A majority of our coronary bypass surgeries are either high risk, reoperations or performed with complex valve or aortic procedures.
Multiple Arterial Bypass Grafting procedures are performed NEARLY 3x MORE OFTEN THAN THE NATIONAL AVERAGE
Despite our high-risk patient population with complex disease and comorbidities, for patients undergoing bypass surgery at the Frankel CVC:
We utilize significantly fewer blood transfusions
We liberate patients from the ventilator faster than STS national averages.
NOVEL CLINICAL TRIALS
Some of our current coronary disease clinical trial offerings include:
• ROMA Trial – Dedicated to women, who tend to be at higher risk and poorly studied in prior trials, to improve coronary bypass outcomes.
• RECHARGE Trial – Comparing stents versus heart bypass surgery specifically for women and minorities as prior studies have not evaluated these groups adequately.
• COSIRA II Trial – Evaluating a novel coronary sinus occluder device for patients who have continued symptoms but do not have bypass or stent options, or have vessels too small for intervention.
For information about our many active clinical trials, visit UMHealthResearch.org.
