Duke's Program for Advanced Coronary Disease provides compassionate multidisciplinary cardiovascular care for patients who have been deemed not optimal candidates for cardiac revascularization.
We draw from our vast experience of managing patients with complex heart disease already in existence at the Duke Heart Center.
Some 85 percent of our patients improve to the extent that they can return to performing most daily activities.
We perform patient evaluation predominantly in the outpatient setting and usually it involves several visits to a cardiologist. All relevant medical records and prior diagnostic tests will be reviewed, and additional diagnostic tests, such as cardiac MRI, may be obtained if necessary.
The evaluation will use a multidisciplinary approach where prior or new diagnostic tests are reviewed by clinical cardiologists with expertise in both invasive and non-invasive approaches to severe cardiovascular disease, as well as cardio-thoracic surgeons with expertise in all aspects of cardiovascular disease.
The cardiac team will form a plan that will then be executed collaboratively with the patient and one of the team members.
As part of the initial evaluation, an extensive evaluation will focus on secondary prevention. For each patient, patient-oriented goals for blood pressure, lipid values, exercise, and diet interventions will be established. Educational material will be provided using web-based technology that allows patients to access the information irrespective of location.
Diagnostic capabilities of the program includes standard approaches such as nuclear, imaging, and invasive tests such as cardiac catheterization using enhanced capabilities including intravascular ultrasound and direct coronary flow measurements. Specialized non-invasive methods such as cardiac MRI and CT angiography will be used as clinically appropriate.
Once a treatment plan has been drawn up, patients will be treated as much as possible in their local community.
The Program for Advanced Coronary Artery Disease specializes in newer treatment modalities for patients with complex heart disease. We use a team approach to optimize and pick the overall best treatment strategy for each patient.
In some cases, this may involve using standard treatment methods such as percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) surgery, and valve repair or replacement, including newer minimally invasive approaches, but with newer supportive approaches.
Team-based approaches include:
In addition to these, a residential program (Healthy Hearts) is offered that uses exercise training and a multidisciplinary approach with exercise physiologist, dietitian, and psychologist to provide a holistic approach to patients with advanced coronary artery disease.
To set up an evaluation, please call 919-681-5816.
Physicians offering this service include:
This service is available at: