CHIP and CTO Program at The Christ Hospital

Complete Coronary Revascularization in Higher-Risk and Indicated Patients Program  

The Christ Hospital Health Network's Complete Coronary Revascularization in Higher-Risk and Indicated Patients (CHIP) program offers treatments that restore blood flow to the heart (coronary revascularization) in high-risk patients. It is the only comprehensive program in Ohio dedicated to treating patients with complex coronary artery disease, including:

  • Left main disease

  • Multi-vessel coronary artery disease

  • Calcified lesions that need minimally invasive surgery to remove (atherectomy)

  • Bifurcation and trifurcation lesions

  • Chronic total occlusions (CTOs)

Chronic Total Occlusions (CTOs)

Chronic total occlusions is a type of heart disease where an artery becomes completely blocked. This prevents blood from getting to the part of the heart supplied by the artery. Without enough blood flow, the heart does not receive the oxygen and nutrients it needs to function properly.

CTO image.JPG

Symptoms of a chronic total occlusion

If you have coronary artery chronic total occlusion, you may experience:

  • Chest pain

  • Trouble breathing

  • Tiredness

Treatment options for chronic total occlusion

Historically, people with a CTO who have these symptoms require a coronoary bypass graft (CABG) surgery to increase blood flow to the heart. However, it is not the only treatment available.

Today, it is now possible to treat CTO through a less invasive technique called percutaneous coronary intervention (PCI) or angioplasty. In this procedure, the blocked artery is opened using balloons and stents.

Chronic Total Occlusions at The Christ Hospital

Shockwave Intravascular Lithotripsy (IVL)

Our heart and vascular team was the first in the Midwest and second in the country to successfully treat a patient with Shockwave's Intravascular Lithotripsy (IVL). Coronary IVL is a novel investigational therapy designed to treat calcified arterial blockages with sonic pressure waves. Dr. Dean Kereiakes, international co-principal investigator and Dr. Robert Riley, Christ Hospital principal investigator believe this therapy holds tremendous potential from a safety perspective for patients, and an ease of use perspective for physicians.

IVL has adapted the use of lithotripsy to cardiovascular intervention with the aim of creating the safest, most effective solution for the growing challenge of cardiovascular calcification. Lithotripsy has been used to successfully treat kidney stones for over 30 years. By integrating lithotripsy into a modified balloon catheter, physicians can prepare, deliver and treat calcified arterial blockages using a familiar technology.,

Shockwave IVL System works by delivering ultrasonic energy through the depth of the artery wall, modifying calcium throughout the entire artery.

The IVL System includes a generator, connector cable and a family of IVL catheters designed to treat both peripheral and coronary arterial disease. IVL allows for optimal stent expansion which will hopefully, provide better long term outcomes following stent placement.

The CHIP team also evaluates treatment options for patients who:

  • Have been turned down for surgery due to risk factors

  • Prefer to avoid open heart surgery

  • Are looking for a second opinion for their coronary artery disease treatment 

For more information or to schedule an appointment call 513-564-2447 (CHIP).

CHIP at The Christ Hospital Health Network

Our care team includes experts in different specialties. They thoroughly evaluate patients facing complex coronary artery disease. Doctors, surgeons, patient coordinators, nurses, and other specially trained staff members work together treat these conditions. This helps provide care that goes above and beyond any other hospital in the region. 

When you or a loved one is referred to The Christ Hospital Health Network's CHIP Program, one of our coordinators will reach out to gather information and help schedule appointments. The coordinator will be by your side throughout the process to ensure you meet treatment goals at every step. 

You will also meet with one of our specially trained physicians. The doctor will talk to you about treatment options based on your medical history and personal preferences. 

Dr. Robert Riley, along with Dr. James Kong and Dr. Joel Reginelli, leads our CHIP Program.

Dr. Riley, is an interventional cardiologist who cares for patients with complex and high-risk coronary artery disease. He’s active in clinical research and regularly publishes work focused on revascularization procedures for high-risk patients. Dr. Riley also co-edits a monthly newsletter on high-risk stenting procedures (percutaneous coronary intervention or PCI procedures). He is also hosting the Midwest Regional CHIP Forum in August 2018.

A HEART team approach

The Christ Hospital Health Network's CHIP Program team takes a HEART approach to each patient. This means each treatment decision is a collaboration between team members who specialize in different areas of cardiology. Team members meet several times a week to discuss cases and treatment strategies, so each patient receives the most advanced and well-rounded care. 

Our HEART team is made up of specialty-trained experts in cardiology, including:

  • Interventional cardiologists

  • Cardiac surgeons

  • Heart failure physicians

  • Heart transplant physicians

  • Cardiac imaging specialists

  • Electrophysiologists 

HEART collaborative leaders

Cardiothoracic surgery


Dr. Geoffrey Answini 

Heart failure

Dr. Eugene Chung 

Dr. Gregory Egnaczyk 

Cardiovascular intensive care (ICU)

Dr. Timothy Smith

Stenting treatments (PCIs) for chronic total occlusions (CTOs)

Dr. Robert Riley

Carl and Edith Lindner Center for Research and Education

Dr. Dean Kereiakes