Why This Page Exists
As a heart failure and transplant cardiologist, my own practice focuses on medical management of heart failure, transplant and LVAD care, and general cardiology — not on performing catheter-based interventions, heart surgery, electrophysiology procedures, or structural heart procedures myself. When one of these is the right next step for you, I'll refer you to a trusted colleague who specializes in it, and I'll stay involved in your overall care. This page explains what those procedures are and who typically performs them, so a referral to another specialist makes sense rather than feeling like being passed along.
Interventional Cardiology: PCI (Angioplasty & Stents)
Performed by an interventional cardiologist — a cardiologist with additional training specifically in catheter-based treatment of blocked arteries. If your heart catheterization shows a blockage that needs treatment, an interventional cardiologist opens it with a balloon and typically places a stent. (See Procedures & Devices for what this procedure involves.)
Cardiac Surgery: Open-Heart Surgery (CABG, Valve Surgery)
Performed by a cardiothoracic (cardiac) surgeon. This includes coronary artery bypass graft (CABG) surgery for extensive coronary artery disease, and open surgical valve repair or replacement for valve disease that needs surgical correction rather than a catheter-based approach. I work closely with cardiac surgery colleagues to determine when surgery is the right recommendation and to manage your care before and after.
Electrophysiology (EP) Procedures
Performed by an electrophysiologist — a cardiologist with additional specialized training in the heart's electrical system. This includes catheter ablation for arrhythmias (like atrial fibrillation or certain fast heart rhythms) — a procedure that maps and then selectively treats the specific tissue causing an abnormal rhythm — and implantation of pacemakers, defibrillators (ICDs), and CRT devices. If you have a rhythm problem or need a device, I'll refer you to an electrophysiologist while continuing to manage your overall heart failure or general cardiac care.
Structural Heart Procedures (Including TAVR)
Performed by a structural heart cardiologist, often working alongside cardiac surgery as part of a "heart team." This includes catheter-based treatments for valve disease — most notably TAVR (transcatheter aortic valve replacement) for aortic stenosis, but also newer catheter-based options for mitral and tricuspid valve disease — as alternatives to traditional open-heart valve surgery for appropriate patients. (See Valvular Heart Disease for the underlying conditions these procedures treat.)
How Referrals Work in Practice
- I identify when one of these procedures is likely the right next step based on your evaluation and testing
- I refer you to a specific colleague or team I trust, and communicate directly with them about your case
- I typically remain your primary cardiologist for ongoing heart failure, transplant, or LVAD management, coordinating with the specialist performing the procedure
- After the procedure, I stay involved in your longer-term care, working alongside the specialist as needed
Common Questions
Why aren't you doing this procedure yourself?
Because each of these areas — interventional cardiology, cardiac surgery, electrophysiology, and structural heart disease — requires its own additional years of specialized training beyond general cardiology, similar to how a heart failure and transplant cardiologist has specialized training in that specific area. Referring you to the right specialist means you get someone who does that specific procedure regularly and expertly.
Will I lose you as my cardiologist?
No — for most patients, I remain your primary cardiologist throughout, coordinating your overall care even while a colleague performs a specific procedure.
How do I know which specialist is right for my situation?
That's exactly what the referral conversation is for — I'll explain why a specific procedure and specialist make sense for your particular situation, and you're always welcome to ask questions before moving forward.
Can I get a second opinion on whether I need the procedure at all?
Absolutely — a second opinion, whether from within the same health system or elsewhere, is a completely reasonable request for any significant procedure recommendation, and a good specialist won't be offended by the question.