Complex and Higher-Risk Indicated Procedures (CHIP) Program

The Heart and Vascular Center’s Complex and Higher-Risk Indicated Procedures (CHIP) Program treats patients with complex coronary artery disease.

The program is for patients whose symptoms are not being controlled and are on optimal medical treatment. There are varied reasons why a patient with complex coronary artery disease may not receive adequate revascularization, a procedure to restore blood flow to the heart. Reasons may include advanced age, prior surgery or bypass operation, complex anatomy requiring specialized equipment, or illnesses such as diabetes, or lung, kidney or vascular disease.

Interventional Treatment Options

The CHIP Program provides comprehensive patient care management and treatment, and coordinates care with other specialty services when needed.

For many CHIP Program patients, catheter-based and minimally invasive interventional procedures are alternatives to open-heart surgery. Benefits may 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: rotational, orbital, laser
• 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.
• Chronic total occlusions
• Left main interventions
• Protected percutaneous coronary intervention (PCI) using cardiac support with Impella^®

A Team Approach to Treatment

Our care team includes interventional cardiologists, cardiothoracic surgeons, anesthesiologists, and medicine specialists. Each patient receives a physician consultation to determine treatment options. The risks, benefits, and alternatives are reviewed carefully with the patient/family to determine the care plan. After assessment, we will coordinate a care plan, which also includes follow-up after a procedure.