Cardiothoracic Guidance, One Call Away
Hi there!
Our Cardiothoracic Surgery Concierge service is dedicated to elevating the patient’s surgical experience through day and night. We offer our tailored guidance before or after surgery too. Our nationally certified clinician delivers expert tele-health support, ensuring continuity, clarity, and safety for your loved ones at every stage on-demand. We work in and out of the operating room, and understand what it takes to get you back to living your best life after cardiothoracic surgery. Services are offered for patients or families who seek to reduce anxiety, gain confidence, need medications (we’'ll connect with your surgeon if requested), or want 24/7 guidance. Our team never wants to let a patient “fall through the cracks”, so we try our best to deliver the best medicine possible via patience and accessibility. The transparent, flat-rate packages offered below make high-level care after Heart & Lung surgery affordable—without compromising quality. Contact us any time to find out if we are right for you!
*We are an independent practice offering tele-health services not affiliated with any hospital organization
Joshua Puig PA-C
Cardiothoracic Surgery (2013-Present)
Studied at the University of Texas, Rio Grande Valley
Master’s of Physician Assistant
Bachelor in Clinical Laboratory (Summa Cum Laude)
About Us:
Our goal as Cardiothoracic Surgery Concierge clinicians is to deliver a premier level of peri-operative surgical support 24/7 for patients and their loved ones. Our company is led by Joshua Puig, a nationally certified Physician Assistant supervised by Cardiothoracic Surgeon Dr. Jonathan Christian Cash, together they offer over 20 years of experience in the field. Having assisted prestigious surgeons in the operating room and guided hundreds of patients through recovery, our practice brings direct access to specialized care. We provide personalized tele-health consultations, patient advocacy, meticulous recovery planning, and attentive follow-up designed to restore confidence and peace of mind. Every detail of care reflects our commitment to excellence, discretion, and compassion—ensuring each patient receives the highest standard of support throughout their surgical journey.
Which condition or diagnosis can we assist you with?
Cardiac Conditions & Procedures
Coronary Artery Disease
Coronary artery bypass grafting (CABG)
Endoscopic vein harvesting or radial artery harvesting
Minimally invasive or robotic CABG
Off-pump (beating heart) bypass surgery
Hybrid coronary revascularization
Heart Valve Disease
Aortic valve stenosis, bicuspid aortic valves, aortic valve regurgitation (aortic valve replacement w/ mechanical or bioprosthetic)
Mitral valve regurgitation, mitral valve stenosis, mitral valve repair or replacement
Tricuspid valve repair or replacement
Minimally invasive or robotic assisted valve surgery
Transcatheter valve interventions (TAVR, MitraClip)
Aortic Disease
Ascending aortic aneurysm repair or surveillance
Aortic root replacement (Bentall, David procedures)
Aortic dissection (Type A, Type B)
Arch reconstruction / hybrid endovascular aortic repair
Cardiac Arrhythmias
Surgical treatment or medication options for atrial fibrillation (Maze procedure, Amiodarone, Ect.)
Left atrial appendage clipping
Cardiac Tumors
Excision of cardiac myxoma, thrombus evacuation, or other intracardiac masses
Pericardial Disease
Pericardiectomy for constrictive pericarditis
Pericardial window creation for pericardial effusion
Thoracic Conditions & Procedures
Lung Conditions
Lung tumors (adenocarcinomas, carcinoid tumors, small cell carcinomas, granulomas, and more)
Lobectomy, segmentectomy, or wedge resection for lung cancer
Video-assisted thoracoscopic surgery (VATS) or robotic lung resection
Lung biopsy for diagnosis
Bullectomy for emphysema or pneumothorax
Pleurodesis for recurrent pneumothorax or effusions
Mediastinal & Chest Wall Disorders
Resection of mediastinal tumors (e.g., thymoma, cysts)
Pectus excavatum or pectus carinatum repair
Chest wall reconstruction
Pleural & Diaphragm Conditions
Decortication for empyema or trapped lung
Diaphragmatic hernia or paralysis repair
Pre and Post-Operative Concerns (patient education)
Activity or recovery expectations for patient and families
Post-operative complications
Care and infection monitoring
Chest tube management
echocardiogram, EKG, chest xrays, CT scan results
Shortness of breath or fluid retention
Edema of the legs
Heart rhythm irregularities (atrial fibrillation, bradycardia, PVCs)
Blood pressure and medication management
pain management
patient advocacy
Referrals to cardiothoracic surgeons with specialized expertise near you
Contact Us
Interested in working together? Fill out some info and we will be in touch shortly. We can’t wait to hear from you!