Cardiac surgeon brings the ‘Miami Method’ to UHealth

By Ana Veciana-Suarez

Cardiac surgeon brings the ‘Miami Method’ to UHealth

By Ana Veciana-Suarez
Dr. Joseph Lamelas, a renowned expert in various forms of minimally invasive cardiac surgery, joins the Miller School of Medicine and UHealth.

From a very early age, Dr. Joseph Lamelas knew his calling.

His uncle, who was a physician, introduced him to the miracles of the operating room and, fascinated by surgery, a young Lamelas never doubted he would grow up to be a doctor working with his hands.

“It’s been my dream since I was a child,” he said.

The dream of that young Cuban-American refugee child came true. Lamelas is a world-renowned expert in various forms of minimally invasive cardiac surgery, having pioneered a series of techniques known as the “Miami Method.”

A surgeon for 29 years, Lamelas has performed more than 16,000 cardiac surgeries — 7,000 of those minimally invasive — and trained close to 1,000 fellow physicians. He is also the only surgeon in the world who uses a minimally invasive method — not splitting the sternum to get to the heart — to replace an ascending aorta.

Now Lamelas has returned to Miami, where he began his medical career back in 1990. After two years at the Baylor College of Medicine, he felt he had accomplished what he had set out to do in Texas. What’s more, the possibility of “leaving a legacy” in his adopted hometown, as chief of cardiothoracic surgery at the well-respected University of Miami Health System, was immensely attractive.

“A university setting,” he said, “allows you to commit fully to innovation. I’ve always been interested in clinical research as well as contributing to the field of cardiac surgery.”

Now, in addition to seeing patients, he is able to share his knowledge with cardiac surgeons in training as a professor of surgery at the Miller School of Medicine. Currently, most of the physicians he has trained are already working in the field. “It’s important to learn early,” he said. “Surgery is like a language. It’s better if you learn it when you’re starting out, and the more you perform surgery, the more your skills improve.”

Lamelas’ “outstanding clinical skills, outcomes and innovation in cardiac surgery,” are welcome in an already strong department, said Dr. Edward Abraham, executive vice president for health affairs and CEO of UHealth. “His arrival at UHealth strengthens our luminary program in cardiovascular disease. Because of his expertise, we expect that patients will not only come from South Florida for surgery but also nationally and internationally. Having Dr. Lamelas as chief of cardiothoracic surgery at UHealth establishes us as the preeminent center for cardiovascular disease in South Florida, and as one of the truly elite institutions in the country.”

For Lamelas, the journey to preeminence was not without its obstacles. In early 1963, when he was only two years old, his family fled Cuba to the United States on a Red Cross boat that also carried a handful of Bay of Pigs political prisoners. The elder Lamelas, educated as a pharmacist, had been a successful business owner with a string of department stores on the island, but by the time the family, including two grandmothers, landed in South Florida, the Lamelas family had lost everything. Like so many other Cuban exiles, they were processed at the Freedom Tower on Biscayne Boulevard and his father was forced to take on a series of menial jobs to survive. To make ends meet, the family shared a home with other families and when a younger brother was born in the U.S., the infant slept in a dresser drawer.

Eventually, the Lamelas family moved to New York, where his father worked first in the grocery business and then bought a delicatessen in Corona, New York. By the time he was in high school, they would move to West Palm Beach, Florida.

“Like so many other Cubans, we had a very hard beginning,” he recalls. “It’s inconceivable to me now what my parents went through.”

Yet, it was that hard beginning that instilled in him a strong work ethic and inspired him to pursue higher education. His parents repeatedly reminded him that while a dictatorship could confiscate physical wealth, knowledge and a college degree would prove to be both more useful and portable.

“I learned early on the value of education,” he said. “No matter where you are, no one can take that from you. You carry it with you, always.”

Even now, he admits to being obsessed with cardiac surgery. Aside from exercising on an elliptical, “I don’t really have any hobbies. I think about it [surgery] day and night. I compete only with myself, not with anybody else. I aim to improve my surgical skills and techniques on a daily basis.”

His brothers also learned those lessons. His eldest sibling became an emergency room physician and created the South Florida-based MD Now Urgent Care Centers, which he sold to a private equity firm last year. His younger brother is a businessman, too.

Unable to afford a U.S. program, Lamelas eventually attended medical school in the Dominican Republic and completed his general surgery residency at The Brooklyn Hospital Center and then his cardiovascular and thoracic surgery residency at The State University of New York Health Science Center, also in Brooklyn, where he would spend seven years. He never wavered from his lifelong commitment to cardiac surgery.

“The results with cardiac surgery are pretty immediate,” he said. “You perform a big operation on a very sick patient and there is immediate gratification because the patient improves rapidly.” A devotee of painting and sculpture, he also saw surgery as an art as well as a science.

In 1990, Lamelas headed south to Miami to launch his practice, but after 13 years he wanted to try something different. “I wanted to do something that would make a difference. I was doing other kinds of [cardiac] surgery, but I was very interested in what they were doing with minimally invasive techniques in other fields.”

In traditional cardiac surgery (open heart surgery), the chest is opened and the heart is stopped while a machine does the pumping as the surgeon operates. A hospital stay of several days is required and recovery can take months. In the minimally invasive procedure that Lamelas helped pioneer and perfect, an incision less than two-inches is made on the right side of the patient’s chest between the ribs – “less than the size of a finger,” as Lamelas puts it — and, using special instruments that he helped to create and patent, access is gained to the heart. This minimally invasive approach enables most patients to go home in about three days, with less tissue trauma, scarring, and pain. Risk of infection is also lower and healing is quicker.

Over the years, Lamelas has developed a series of repair-and-replacement valve techniques that he has dubbed the “Miami Method.”

When asked how he came up with the name, he laughed. “I wanted the city to get credit.”

After several medical device companies shrugged off his request, he worked with a patient, who was an engineer, to develop special operating tools now used around the world.

He began by operating only on the aortic and mitral valve and expanded the minimally invasive techniques to double and triple valve surgery, ascending aortic surgery, tumor removal, and even congenital cardiac defects. “The Miami Method,” he said, is unique because, “I don’t utilize only one technique, because there are no two valves that are exactly alike.”

In Miami, there is potential for even more innovation. “I’ve always believed South Florida should have a pillar cardiac surgery program within an academic institution,” he said, “and I truly believe that my drive and motivation along with the support of the University of Miami will make that happen.”