Dr. Mark Malias, a cardiothoracic surgeon at the Welsh Heart Center at Cleveland Clinic Indian River Hospital, resigned last week. Malias is the latest in a string of more than a half-dozen departures from the hospital’s much heralded Heart Center. His departure marks the first to leave a gap in care – however temporary – at the Vero hospital: lung surgery.

Until he is replaced, Malias’ departure means patients requiring lung surgery – including for cancer – must face a commute to Stuart’s Martin Health North in order to get Cleveland Clinic care. Martin North is 1 hour and 10 minutes away from Indian River Hospital.

Some may opt to leave the system and get care elsewhere.  The nearest option would be Steward Sebastian River Medical Center, where Dr. Michael Greene is a well-regarded cardiothoracic surgeon doing both thoracotomy and robotic lung surgery.

Others may seek treatment at Lawnwood Regional Medical Center in Fort Pierce, or head north to Brevard County’s Holmes Regional Medical Center, 47 minutes away. 

Another option would be to wait until Cleveland Clinic’s recruiting efforts, said to already be underway, are successful. The hospital says it is searching for not one but two doctors to replace Malias.

“Cleveland Clinic Indian River Hospital is recruiting for two new cardiothoracic surgeons,” the hospital said in a statement. “That includes a thoracic surgeon and a second surgeon who will focus primarily on cardiovascular surgery. In the interim we will utilize resources from Cleveland Clinic Florida to provide ongoing thoracic lung surgery while we are actively recruiting these positions. We anticipate filling these positions in the very near future.”

Malias, a Princeton graduate who trained at the University of Louisville and the University of Florida, was recruited from Holmes Regional in 2008 by Dr. Cary Stowe, the founder of the Welsh Heart Center. Stowe, a revered cardiac surgeon who came to Indian River from Florida Hospital in Orlando in 2006, was the first of the Heart Center doctors to leave Cleveland Clinic Indian River. He retired a year ago. In March of this year, his replacement as heart center director was named: Dr. Mariano Brizzio, who arrived just before Stowe left.

For a decade before that, Stowe and Malias worked together to personally choose the heart center doctors and staff that together with the affiliation of Duke University Health built a program strong enough to lure Cleveland Clinic to Vero. Much of that was funded through Vero philanthropy, specifically the donations of Pat and Carol Welsh, for whom the center was named.

Prior to the arrival of Stowe and Malias, heart patients in Vero had to leave town for complex surgeries; both surgeons had already operated on hundreds of Vero patients in Orlando and Melbourne by the time they came here.

It was an outsized program from the start in terms of excellence. Most hospitals with such advanced care offerings typically have far greater patient volumes than the Vero hospital. Those volumes support the most complex care, both in terms of the frequency needed to keep skills honed, and in terms of expense. Cardiothoracic surgeons typically have eight years of training above and beyond their four years of medical school.

Brizzio, the remaining surgeon, works only on the heart. Malias, and to a lesser extent Stowe, performed lung surgeries in addition to heart surgeries, though when he left, Malias’ practice involved 75 percent cardiac care.

“He’s an excellent surgeon, an exceptional talent,” said Dr. Ted Perry, himself a highly regarded surgeon who left Cleveland Clinic a few months ago and is now in private practice. Perry called Malias’ departure “disappointing,” noting his name lengthens the list of top doctors no longer employed by the hospital.

Dr. Brian DeoNarine, an independent cardiologist, called Malias “a great surgeon,” one he was glad to be able to use for referrals. “He’s done a lot for the community,” said DeoNarine. “It’s sad to see him leave. They didn’t make it easy for him to stay.”