Jupiter Medical Center is the first in the region to use minimally invasive direct coronary artery bypass surgery to treat heart blockages and the Neuroguard IEP System for treatment of carotid disease.
Open-heart surgery is not the only solution for some patients at JMC who have one or two blocked coronary arteries when stents aren’t an option.
In 2024, JMC cardiothoracic surgeon Dr. Vivek Patel and his team performed JMC’s first minimally invasive direct coronary artery bypass (MID-CAB) surgery and, by the summer of 2025, had completed a dozen more.
It is an alternative to the traditional coronary artery bypass grafting (CABG) surgery, first developed in the 1960s. The method is “still one of the most effective ways of treating blockages in the heart,” Patel says. “Frequently, patients can’t be treated with stents, depending on where the blockage is located, their age, and other health conditions.”
Open-heart surgery requires a large incision and cracking the breastbone to access the heart. “Recovery can be extensive,” Patel says, “especially if they’re older and frailer—as long as three months.”
Patel has also completed four or five mitral valve robotic surgeries that are typically done as open-heart surgery. Using minimally invasive techniques “opens the door to doing a lot of other heart surgeries traditionally done through large incisions—aortic valve, tricuspid valve, heart tumors, arrythmia surgery,” he says. “We’ll continue to push the frontier of what we can do.”
Patients who are selected for MIDCAB can expect several benefits from the advanced robotics and endoscopic camera-based technology:
A faster recovery and return to normal physical activity are key benefits. “Certainly, we know the reduced time it takes for somebody to recover is associated with less depression,” explains Patel.
Candidates are carefully selected by the JMC team. If patients have more than one or two blocked vessels, open-heart surgery is necessary for access. “And some patients have other problems—heart valve, atrial fibrillation—you need to fix,” Patel says. “It requires full exposure to fix all the problems at once.” Other disqualifying factors: having scar tissue from previous lung or open-heart surgeries, being morbidly obese, or having an enlarged heart.
JMC Stroke Program Director Dr. Juan Gomez is using the latest stent technology for treating carotid artery blockages with minimal risks.
The narrowing or blockage of one or both carotid arteries is called carotid artery stenosis. Carotid artery disease (CAD), which Gomez describes as “a buildup of plaque blocking the normal blood flow to the brain.” Carotid artery stenosis, he explains, “significantly increases the risk of stroke due to a decrease in blood flow to the brain or a plaque rupture, which can lead to a blood clot that can travel to the brain.”
Carotid artery stenting—in use for several decades—is clinically proven to help alleviate the symptoms of CAD and minimize the risk of stroke. However, there had been little innovation over the past two decades—until the new Neuroguard IEP System received Food and Drug Administration approval last fall.
In January 2025, JMC was the first facility in South Florida to use the Neuroguard IEP System. “Since then, we have become among the top users in the state and the country—with a zero-complication rate to date,” Gomez says.
The 3-in-1 system combines a stent, balloon, and filter into one single unit, making the procedure quicker and safer, Gomez says. The microfilter’s miniscule pores capture microparticles to prevent them from traveling to the brain and causing a stroke. “Preliminary clinical studies with the Neuroguard IEP System had the lowest one-year stroke rates ever shown for any type of carotid artery procedure,” Gomez reports. “During the procedure, there is continuous flow to the brain, as opposed to other available modalities.”
“Carotid angioplasty and stenting are no longer limited to high-risk patients,” Gomez says.
Most patients with carotid artery stenosis have no symptoms until they experience a stroke or a transient ischemic attack (known as a TIA), which has stroke-like symptoms that resolve within 24 hours. Symptoms include sudden weakness or numbness on one side of the body, trouble speaking or understanding speech, sudden vision loss, and dizziness or loss of balance.
Current Centers for Medicare & Medicaid Services guidelines state that angioplasty and stenting of the carotid artery is indicated for: