Manchester, N.H.-based Elliot Health System is taking the next step in overhauling cardiovascular care for New Hampshire’s most densely populated region, formally launching the Elliot Heart and Vascular Center at Elliot Hospital in January.
The center unites cardiology, vascular surgery and the system’s newly added heart surgery program under one roof, a move leaders describe as both a natural evolution and a critical expansion of access, bringing the full spectrum of cardiovascular care back to Manchester in a coordinated, patient-centered model.
For Greg Baxter, MD, president and CEO of Elliot Health System, the expansion reflects a longstanding goal: ensuring that patients in and around Manchester have convenient, reliable access to the full continuum of heart and vascular care. In his view, the story begins with a single priority.
“I think the critical word is ‘access,’” Dr. Baxter told Becker’s.
Closing the last gap in cardiovascular care
Elliot has long provided advanced cardiology and vascular services but relied on other institutions when patients needed open heart surgery. As regional dynamics shifted, including challenges at nearby cardiac programs, leaders saw an opportunity to stabilize access and keep patients closer to home.
Dr. Baxter noted that while Manchester once had an enduring cardiac surgery presence, access to consistent, high-quality cardiology services had become increasingly unreliable in recent years.
As conditions changed, several community cardiologists approached Elliot’s leadership, concerned about their ability to continue delivering high-level care.
Dr. Baxter said Elliot was in a position to support those clinicians.
“We found ourselves fortunate to have the resources and were attractive to those providers who live in the community,” he said.
Elliot rapidly recruited several cardiologists and, with board support, moved to build a full-spectrum heart and vascular program that included onsite cardiac surgery.
That step, Dr. Baxter said, was essential not just for patients needing valve or bypass procedures, but also to unlock the full potential of the cardiology program.
A surgeon with thousands of cases — and time for 5 a.m. conversations
To lead the program, Elliot recruited cardiac surgeon Gerald Sardella, MD, who has practiced in the field for nearly 30 years.
Dr. Sardella said his experience practicing in both New Hampshire and New York has given him a broad perspective on how regional trends and institutional stability influence care.
“The New Hampshire population is slowly increasing over time, mostly from the south coming north, and I can tell by the traffic patterns they’re increasing,” he said. “I thought this was a good opportunity for me to serve the patients of the community.”
What stood out to him at Elliot, he said, was a culture that prioritizes patients and families — not volume.
That culture shapes his approach to care. He meets every surgical patient in person, even those arriving at 5 a.m. on the day of surgery, and checks on them daily throughout their stay.
“When you make a phone call now, you get a recording. You don’t get people, you don’t get the face time,” he said. “Here at The Elliot, they get the surgeon 100% of the time – not just in the operating room, but before and after surgery.”
He sees surgery as a rare, often once-in-a-lifetime event and strives to make it a positive experience — something he believes patients increasingly value.
Building a program around relationships, not a ‘conveyor belt’
The cardiac surgery program performed its first open heart surgery in July and is on track for its 23rd case.
Dr. Sardella said the volume is less important than the model: a tight-knit team of experienced advanced practice providers and nurses, many of whom have worked with him for years.
That team-based model is designed to contrast with the high-volume, layered structures often seen at large academic centers.
“I’ve been in a lot of different situations, different hospital algorithms of how they handle cardiac patients,” Dr. Sardella said. “At some institutions, it was kind of the conveyor belt-type of mentality. I’d rather focus on the patients and the families. It’s more rewarding that way.”
He describes his daily rounding as both clinical and social — an opportunity to assess subtle changes and build trust. One patient with chronic respiratory issues, he noted, has pushed herself in recovery in part due to that bond.
“That bond is something. It’s unique, and it will never be broken,” he said. “It takes time, effort, and that’s what you have to put into it. I was trained that way — to take care of the patient one at a time and not rush through anything.”
Dr. Baxter said that commitment was exactly what Elliot sought when designing the program.
“We were seeking high-quality care and great outcomes, but we were really looking for a personalized feel to it, which we thought was a competitive advantage,” he said. “We simply found people who aligned with what we wanted to do.”
Keeping advanced care in Manchester
While the early focus has been on safely building surgical volume, the broader strategy is to establish Elliot as a comprehensive heart and vascular destination — so patients no longer have to travel to Boston or elsewhere for advanced procedures.
Dr. Sardella said many New Hampshire residents are reluctant to make that drive, even if it’s merely an hour away. Strengthening services locally — and offering a more intimate model — can change that.
Looking ahead, Elliot’s heart and vascular program plans to add structural and electrophysiology services, including the Watchman device, left-sided atrial fibrillation ablations and transcatheter aortic valve replacements.
Keeping those services in Manchester, he said, will further reduce care fragmentation.
Prevention first, technology second
Even as Elliot expands its complex care capabilities, Dr. Baxter emphasized that the ultimate measure of success isn’t volume — it’s prevention.
He sees the center as a hub connecting primary care, prevention and specialist-driven risk management.
“We aim to be a truly comprehensive resource, bringing together primary care and specialty teams to focus on prevention, early diagnosis, screening and proactive management of lipid disorders and hypertension,” he said. “The goal isn’t to funnel as many people as possible into a cardiovascular program. It’s to ensure that as few people as possible actually need those high-intensity services.”
That means investing in community education around the signs of heart attack and stroke, and supporting behavior changes that reduce long-term risk.
Returning to the ‘grassroots’ of cardiac care
Both leaders believe the future of cardiac surgery access depends as much on model and culture as on technology. Large academic institutions will continue to play a critical role — but community-based programs may differentiate by offering greater intimacy and continuity of care.
“For systems in general, I think going back to the grassroots again is important,” Dr. Sardella said. “Here at Elliot, you want a few valuable people doing the right thing for the patient. That speaks volumes.”
As artificial intelligence and other tools advance, he and Dr. Baxter see human connection as the element patients are least willing to sacrifice.
“People are getting lost,” Dr. Sardella said. “Getting back to the roots is important to me.”
For Elliot, that has meant pairing decades of cardiology and vascular experience with a new surgical program built around face time, consistency and keeping care close to home — all with the long-term goal of helping fewer patients ever need an operating room.
