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Complex Coronary Artery Disease

For patients with complex coronary artery disease, the Heart and Vascular Center provides the Complex and High-Risk Interventional Procedures (CHIP) and Chronic Total Occlusion (CTO) Program.

The CHIP and CTO Program offers non-surgical treatment for patients whose coronary artery disease symptoms are not improving with medication, who are not eligible for cardiac surgery, or cannot be treated with standard interventional techniques. The program also treats CTO, a complete blockage within one or more of the heart’s arteries that requires specialized care. Most program patients have had cardiac bypass surgery, have complex anatomy requiring specialized equipment or other illnesses such as diabetes, lung, kidney or vascular disease.

Interventional Treatment Options

For many patients, catheter-based and minimally invasive interventional procedures are alternatives to open-heart surgery. Benefits include improved outcomes, quicker recovery, and fewer complications. At Yale New Haven Hospital (YNHH), we perform more complex coronary interventions annually than any other hospital in Connecticut. Procedures are performed with advanced imaging using intravascular ultrasound or optical coherence tomography.

Among our comprehensive treatment options at YNHH for complex coronary artery disease:

  • Atherectomy: laser, orbital, rotational
  • Bifurcation and trifurcation interventions
  • Brachytherapy for coronary artery stent restenosis. YNHH has the only coronary brachytherapy program in Connecticut, and one of the largest in the country.
  • Coronary intervention using Impella® device
  • Left main coronary artery interventions
  • Percutaneous coronary intervention for chronic total occlusions
  • Shockwave intravascular lithotripsy

A Team Approach to Treatment

Our care team includes interventional cardiologists, cardiothoracic surgeons, anesthesiologists and heart-imaging specialists. During consultation with the patient and family, the procedure risks, benefits and alternatives are reviewed carefully to determine optimal treatment. After assessment, we will coordinate a care plan that includes follow-up after a procedure.