About the Center

Patients with advanced coronary artery disease (CAD) may have significant challenges with day-to-day activities limited by angina, including walking to the mailbox or even across the room.  Despite these limitations, they may have been offered few to no treatment options to help alleviate the symptoms.

For many years, patients with advanced conditions like totally occluded coronary arteries (CTO) or severe multivessel disease had no options available to them if a surgeon felt they were too high risk for coronary artery bypass surgery (CABG).  But future-focused programs at Georgia Heart Institute provide treatment for these high-risk patients to improve the quality of life for those with complex coronary artery disease.

Conditions & Treatments

Who do we treat?

The Center for Complex Coronary Disease at Georgia Heart Institute offers coordinated and specialized care for patients who have complex coronary artery disease or blockages, but:

  • Have been told they are not good candidates for heart bypass surgery
  • Would prefer not to undergo heart bypass surgery, even if they are a candidate
  • Have been told they are not good candidates for stenting
  • Have been told they have no treatment options, despite the significant impact on their quality of life
Conditions We Treat

Complex Coronary Conditions

With our comprehensive Center for Complex Coronary Disease, Georgia Heart Institute is able to treat a range of coronary heart diseases, from some of the most common conditions to those that are more complicated or severe.

Chronic total occlusions

Coronary arteries serve a critical role in our bodies by supplying blood to the heart muscle. When a coronary artery is blocked, it may deprive the heart of oxygen which can cause pain (angina), shortness of breath, and fatigue.

A chronic total occlusion (CTO) is when a coronary artery is entirely blocked for over 3 months– this may occur in up to a third of all advanced CAD patients.  Some patients with a CTO may be better candidates for a coronary artery bypass, but others may be too high-risk or have other medical issues that make them a poor candidate for surgery. If medications do not improve symptoms and lifestyle then our Center for Complex Coronary Disease can help.

Highly Calcified Blockages

Patients who have a highly calcified blockage may need a procedure called an atherectomy before a stent can be implanted.

Atherectomy is a procedure used to open arteries that have become blocked with plaque, which is made up of fatty substances such as cholesterol topped with a calcified layer. Removing the plaque reopens the artery, which restores normal blood flow. The atherectomy procedure involves the insertion of a device through a catheter into the artery. This device then modifies the calcific plaque which leads to better and more durable stenting outcomes.

Multivessel CAD

Patients with coronary artery disease who have blockages in multiple vessels typically benefit from coronary artery bypass surgery or stenting. For others, the severity of their disease or other medical conditions may have led to other heart surgeons or cardiologists declining to treat them because the risks were felt too high.

Refractory angina

The most common symptom of coronary artery disease, angina is chest pain caused by coronary artery blockages limiting blood flow to the working heart. Patients with refractory angina have recurrent and lasting chest pain that is not controlled with the traditional methods: medicine, heart surgery, or stent placement. For these patients, their symptoms represent a significant day-to-day challenge, but they may have been told before that there were no options to improve their condition.

Treatments We Offer

Coronary Disease Treatments

By their very nature, complex coronary diseases are extremely complex and require multi-faceted care that is equally complex. We ensure that every aspect of coronary heart care is tailored to meet the distinct needs of each person and condition. Our interventional cardiologists, along with the entire multi-disciplinary team, bring an advanced skillset to every treatment we provide, including:

Complex Percutaneous Coronary Interventions (PCI)

PCI describes a set of minimally-invasive approaches that can restore blood flow to the heart to relieve angina. These are typically done through a 2mm IV placed in the radial artery in the wrist. All procedures are performed using intravascular imaging, which optimizes treatments and outcomes. 

Our team at the Center for Complex Coronary Disease offers the most advanced approaches to PCI, including CTO PCI, which is a percutaneous coronary intervention to treat an artery that is entirely blocked.

Why Choose Georgia Heart Institute

Our patient-focused program ensures that those with heart disease have all the state of the art care options available to them. From primary preventative care to those with advanced CAD, we focus on providing effective, high-quality care that helps our patients live fuller lives. Our expertise in PCI, and off-pump bypass and robotic heart surgery set us apart as one of the few cardiovascular programs in the southeast with a comprehensive, minimally invasive program to meet the needs of patients who otherwise wouldn’t have these options to improve their quality of life.

We offer a seamless patient experience, meaning patients can receive the full spectrum of cardiovascular care at Georgia Heart Institute, from non-invasive cardiology to complex coronary interventions. We also offer in-patient appointments and telehealth visits for patients who live further away.