Known for our heart: The history of The Cardiac and Vascular Institute

Known for our heart: The history of The Cardiac and Vascular Institute 

Written by Jay Koons, M.D., of The Cardiac and Vascular Institute

The year 1973 was notable for not only the establishment of what is now HCA Florida North Florida Hospital, but also what is now The Cardiac and Vascular Institute (TCAVI). Cardiology services began at North Florida Hospital on the year the hospital opened its doors when Dr. Howard Ramsey started inpatient care as a solo practitioner.  He opened the first community hospital cardiac catheterization lab in the state of Florida.  He was joined in practice the following year by Dr. Lewis Cintado.  Together, these two individuals were responsible for providing cardiology services for many years.  At that time, much of the work that was done involved valvular heart disease with one cath lab and much more basic equipment than we have now.

This group expanded in 1987 when Dr. Gregory Imperi and Dr. Steven Kraft join them after being recruited following their fellowship at the University of Florida. The group at that time was named Interventional Cardiologists of Gainesville (IVC).  Dr. Imperi worked his entire career with the practice until his retirement three years ago. Dr. Preston Green and Dr. Thomas Plavac were members of the practice in the years between 1989 and 1999.

Physicians who are still in practice include Dr. Jay Koons, who returned to Florida and joined the group in 1995. He was followed by Dr. Dan Van Roy in 1999. The following years were noted for continued growth in volume as well as services provided.  Dr. Christopher Caputo joined IVC in 2003 followed by Dr. Arthur Lee in 2004.  Dr. Mark Tulli joined in 2006 followed by University of Florida fellows Dr. Tim Wessel in 2007 and Dr. Matheen Khuddus in 2008. Dr. Raj Subramanian was added in 2009, bringing modern Electrophysiology services to the practice.

The Cardiac and Vascular Institute was founded May 31, 2012, when IVC merged with the Cardiology Associates of Gainesville (CAG). 

CAG was established in the 1970s by Dr. Gary Cooper.  Dr. Burton Silverstein, Dr. Michael Dillon and Dr. Steven Roark would be added throughout the 1980s.  Dr. Marshall Decker joined in 1994, but sadly passed away of an aggressive brain tumor after a short career. Physicians who are still in practice at TCAVI and were previously with CAG include Dr. O'Meara who joined in 1996, Dr. Andrew Smock in 2000 and Dr. Ann Tong in 2010. Dr. Brian Werbel practiced from 2005 until his retirement.

Numerous cardiologists have been added to TCAVI since the merger of IVC and CAG, including Dr. Suzanne Zentko (2013), Dr. Ilie Barb (2014), Dr. Mike Jansen (2016), Dr. Roja Pondicherry (2018), Dr. Chris Estel (2018), Dr. Nasir Nawaz (2020), Dr. Fernando Ortiz (2021) and Dr. Ryan Chauffe (2022). Dr. Elmer Croushore added vascular surgery services when he joined in 2016.

Unfortunately, 2021 brought the untimely deaths of Howard Ramsey and Burt Silverstein. We as a group all benefitted from their knowledge, work ethic and friendship for many years.

The addition of physicians has allowed TCAVI to provide a wide breadth of non-invasive and invasive cardiac and peripheral vascular services.  Transthoracic and transesophageal cardiac and peripheral vascular ultrasound as well as nuclear isotope imaging are provided in accredited laboratories. Cardiac catheterization procedures are now done in five labs at North Florida Hospital and an outpatient facility. Diagnostic cardiac catheterization, coronary intervention (PCI), high-risk circulatory assisted PCI, cardiac rhythm management with device implantations and arrhythmia ablations are daily procedures. The percutaneous treatment of peripheral arterial, carotid, aortic and venous disease has expanded in both the inpatient and outpatient settings. Management of structural heart disease with PFO/ASD and left atrial appendage closures are common cath lab procedures.

In collaboration with our surgical colleagues, treatment of valvular heart disease has evolved. Transcatheter aortic valve replacement (TAVR) and mitral valve interventions have provided excellent outcomes for both high and low risk patients and avoid open surgical procedures.

An active TCAVI research program has participated in numerous drug and device trials. These efforts contributed to the development of novel procedures for the treatment of coronary and peripheral arterial disease, hypertension with renal denervation, heart failure with coronary sinus interventions and tricuspid valve interventions.

The past 50 years has seen the growth and evolution in quality and breadth of cardiovascular services provided by TCAVI. This would not have been possible without the support and collaboration with HCA Florida North Florida Hospital.