MEDSTAR HEART & VASCULAR INSTITUTE

Capabilities Performance Outcomes

2021-2022 2 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH MedStar Health Locations Map Contact Information Physician Listing Quality andSafety MedSTAR Transport Clinic Alliance Cleveland Zirkin Heart & Vascular Hospital Continuing MedicalEducation Graduate MedicalEducation Research Cardiac Anesthesiologists Cardiac Hospitalists Nursing Advanced Practice Providers Cardiovascular CriticalCare Cardiovascular Imaging Cardiology andPrograms Specialty Heart Transplantation Ventricular Assist Devices(VADs) Advanced Heart Failure Cardiac Electrophysiology Vascular Surgery Aortic Disease Management Cardiac Surgery Interventional Cardiology Structural Heart Disease Table Contents of |

Table Contents of

32 32 31 31 31 31 30 28 24 23 22 20 16 12 10 39 39 38 37 36 36 36 35 34 31 8 6 4 Visit usat MedStarHeartInstitute.org. Stats at aglance MEDSTAR HEART & VASCULAR INSTITUTE guidelines forsafetyincluding proper maskingand physicaldistancingwhere appropriate. Learn more at thephotosinthispublication wereSome of taken priortotheCOVID-19 pandemic. All patients andproviders are expected tofollow thecurrent MedStar Health Please submitanycommentsto charles.m.gill@medstar.net [email protected]. Throughout thisreport, weshare ourbest availabledata. Inmanycases, theCOVID-19 duetotheconsequencesof pandemic, that data isfrom calendar year 2019. physicians Cardiovascular 175+ surgeries annually Mitral valve 172 to date procedures WATCHMAN 563 annually TAVR procedures 506 procedures todate MitraClip 133

®

interpretations annually TEE,and TTE Cardiac MRI, CT, 17,900 annually Cardiac ablations 1,637 annually procedures CABG +AVR 198 annually PCI procedures 2,631 procedures annually Cardiac surgery 2,210

MedStarHealth.org/Safe. studies Current research 175 in 2020 transplantations Heart 29 procedures annually Aortic root elective 58 stroke rates revascularization Carotid <1% in U.S. VAD centers TOP 5

MEDSTAR HEART & VASCULAR INSTITUTE MedStar Heart & Vascular Institute Physician Executive Director Stuart F. Seides, MD and participation inourprograms. ourcommunity at large.the well-beingof Iwelcomeyourcomments, feedback, All that ourpatients wedoissingularlyfocusedonimproving and thelivesof Program, thelargest inthenation. nowoneof University-Washington HospitalCenter Cardiovascular Disease Fellowship training, includingarecentourhighlyselective MedStar Georgetown expansion of clinicaltrialsunderway.dozens of Likewise, wecontinuetoenrichphysician Our groundbreaking research enterprisecontinuestogrow exponentially, with program that hassetthestandard inourregion fornearly fourdecades. Valve Program at Yale NewHavenHealth. acardiac Hetakes surgery thehelmof surgeryas professor andsurgical of theStructural director Heart of andCardiac Cardiacas thesystemchairof Surgery. Dr. Mangicomestousfrom hisposition outstanding leaders intheirfields. Iamdelightedto welcome AbeelMangi, MD, experts atalentedmultidisciplinary cadreOur successistheresult of of superiorclinicianswhointeract andcollaborateof freely withoneanother. A great cardiovascular program isfirstandforemost builtuponacontingent educate ourselves—longafter COVID-19 isnolongeranimmediate threat. will nodoubthaveanimpactonhowwedelivermedicalcare—and continually thishasbeenanearly seamless transitionAll of andtheexperience andcreativity almost overnight. A robust digitalcampuswascreated forcontinuingeducation. replaced in-personencounterswheneverpossible. Conferences turnedvirtual way weinteract with patients andwitheach other. Virtual patient appointments to adaptthantheworldwidecoronavirus pandemic. We quicklyreinvented the There hasbeennogreater oursystem’s testof personalandprofessional ability collaboration. this kindof that spantraditional specialtylines, andour“systemness”connectivitypromotes organ systemsanddisease states demandsanapproach that facilitates linkages quality care. Additionally, theconnectivitybetween ourgrowing understandingof the patient’s entry, pointof itisourpromise that each willreceive thesamehigh- cardiovascular care across thewidegeographic region that weserve. Nomatter This report displaysourcontinueddedication toincreasing understandingof I believetheseattributes are demonstrated inabundance. Vascular InstituteCapabilities Performance andOutcomesReport, inwhich in superiorclinicaloutcomes. Iampleased topresent thisMedStar Heart & specialties, strengthened byanorganization that supports thoseefforts resulting extraordinary breadth knowledgeextending across anddepthof intersecting The aworld-classcardiovascular truehallmarks program of are having Leading cardiovascular care. theevolutionof

| Message from thePhysician Executive Director ­ —

3 CAPABILITIES PERFORMANCE OUTCOMES 4 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH <.4% for interventionsanddevices. approach toachievingsustainableresults. We manage themostchallengingcasesandoften provide secondopinions, aswellalternative options treatmentof optionsanddevicesforpatients withstructural heart disease. Ourmultidisciplinaryteam analyzeseach casetodeterminetheoptimal Drawing from cardiac thecollectiveexpertise surgeons, of interventionalcardiologists, cardiac imagingspecialists, andothers, weoffer thewidestrange Structural heart disease Baltimore region team | Structural Heart Disease replacement (TAVR) aortic stenosisandaortic regurgitation. program intheregion offering TAVR forsevere advancement thereafter. We remain thelargest 2007, servingasaclinicaltestingsiteforevery We havepioneered TAVR sinceitsinceptionin Transcatheter aortic valve ACC Standard .9% Compared to in-hospital TAVR mortality

TAVR procedures 506

for patients withmitral andtricuspidvalvulardisease. As leaders inaortic valveprocedures, wecontinuetoexpand optionsavailable Mitral andtricuspidvalveinterventions Washington, D.C. region team highlights trial Clinical • • • • • • • moderate-to-severe tricuspidregurgitation. The The mitral regurgitation, currently underinvestigation inthe APOLLO trial. We are usingthe the safety andefficacy of We are the secondhighestenroller inthecountryforSUMMIT trial, testingthe as analternative toopen-heart surgery. further annulardilation, anddiminishsymptoms. this investigational percutaneous procedure toreduce regurgitation, prevent Patients withsymptomatic severe mitral valveregurgitation are benefitting from device that Health. wasdevelopedinpartnership withtheNational Institutes of Transcatheter Mitral Cerclage Annuloplasty involvesanewtechniqueand AltaValve In theCLASPIIDclinicaltrial, the are at prohibitive riskforopensurgery. system isbeingevaluated inpatients withdegenerative mitral regurgitation who regurgitation inpatients considered highriskforopensurgery. evaluating itsusefortreatment moderate-to-severe of or severe mitral valve delivered transeptally. theongoing,As part of early feasibility study, weare

TRILUMINATE Intrepid ™ isatranscatheter mitral valvereplacement (TMVR)devicethat is ™ TMVR systemisanewoptionforpatients withsevere, symptomatic CorMatrix study offers atranscatheter cliprepair forpatients with Tendyne ® , anoveltricuspidvalveimplanted surgically. Edwards PASCAL ™ transcatheter mitral valvereplacement system ™ transcatheter valverepair

MEDSTAR HEART & VASCULAR INSTITUTE <2 Weeks Initial referral toprocedure Expedited TAVRprocess one daypost-procedure. discharged homeasearly as procedure, manypatients are in under24hours. After the site, andoften canbecompleted be coordinated andconductedon times, theentire procedure can and dramatically reduced wait workups, fewertripstothehospital, experience. Through expedited TAVR centersaround thepatient advantages, ourapproach to In additiontotheclear clinical TAVR Patient-centered process National average: 7weeks

| Structural Heart Disease • • SAPIENS3 Amplatzer • Para-valvular leak A.valve Aortic Comprehensive structural heart options • Portico • BASILICA • ACURATE • JenaValve forstenosisandregurgitation CoreValve®, Evolut  outflow tract Right ventricular valve Pulmonary ™ (trial) (trial) ™ neo2 ™ VascularPlug Ultra ™ disease

Aortic ValveSystem ™ PRO+

E • AltaValve • • • • • B. Mitral valvedisease • MitraClip • Mitral Dock Tendyne replacement (TMVR)system obstruction-LAMPOON Procedure Novel techniquetoprevent L calcification (MITRAL trial) SAPIEN S3formitral annular via transseptal access Transcatheter mitral valvereplacement ENCIRCLE trialforSAPIENM3System Intrepid    Replacement (TMVR)system F ™ ™ TranscatheterMitralValve ™ ™ transcatheter mitral valve

TMVR A B

D VOT C

• Sentinel® F. Cerebralprotection • • SAPIEN pulmonary valve E. Dysfunctional RVOT conduit/ • • D. Stroke prevention and AFib • occluder • VSD occluder • ASD C. Congenital heart defects • CHAMPION-AF(trial) • A WATCHMAN FLX Melody PFO occluderforcryptogenicstrok  PINNACLE FLX (trial) MPLATZER ® ™ TranscatheterPulmonary Valve 3 Mitral valve ™ Amulet ™ device Aortic valve ™ device(trial) valve Tricuspid e

5 CAPABILITIES PERFORMANCE OUTCOMES 6 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH Hospital Center MedStar Washington Cardiac Catheterization Lab Medical Director degree of experience andexpertisedegree of todiagnosecriticalpatients andtreat complex cases. The specialistsinourcardiac patients, catheterization labsseehighvolumesof affording anelevated Interventional cardiology Lowell F. Satler, MD | Interventional Cardiology

Hospital Center MedStar SouthernMaryland Cardiac Catheterization Lab Medical Director William O. Suddath, MD

25 -30% 25

2,631 Memorial Hospital Memorial Hospital MedStar Union Cardiac Catheterization Lab Medical Director John C. Wang, MD

interventions (PCIs) coronary Percutaneous home sameday Patients return

7,860 door-to-balloon time Source: ACC/AHA National benchmark:90minutes Average primaryPCI 133 chronic total occlusions Success rate PCIsfor of 56 minutes 61 92.5% PFO closures PFO closures to date MitraClips catheterizations Diagnostic

highlights Innovation MEDSTAR HEART & VASCULAR INSTITUTE • • • • Some key innovations include: the latest availabletechnologies, customizedforourpatients. Our extensive involvementinnewresearch provides accessto and often undiagnosed population. evaluation andtreatment forthispreviously underserved Early adaptation of theMitraClipEarly adaptation of page 28. stenoses. Read more about ourimagingtechnologyon evaluate andtreat coronary anatomy andindeterminate such asfractional flow reserve derivedfrom CT, tobetter our Clinical useof the volumescontinuetogrow. Teams system-wide performed56PFOclosures in2019and PFOclosure isanoptimaltreatmentif forpatients withstroke. interventional cardiologists, Center, acollaboration betweenneurologists and The Heart-Brain Team at MedStar Washington Hospital coronary artery disease). A NO-CAD clinicforINOCA (ischemiawithnoobstructive volumes andoffer patients. ittothisexpanded poolof mitral functionalregurgitation, wecontinuetogrow our in patients withsymptomatic moderate-to-severe orsevere MitraClip. Nowthat thetechniquehasbeenapproved foruse performed 133transcatheter mitral valverepairs usingthe state-of-the-art cardiac imagingabilities, | Interventional Cardiology

The objectiveisthorough initially developed to determine initially developedtodetermine ™ . To date, wehave

and private areas towaitwiththeirvisitors. recover inadedicated lounge, with WiFi, iPads, twice theaverage reported bythe ACC. Patients and interventionalprocedures, more than radial bothdiagnostic accessfor90percent of At MedStar UnionMemorialHospital, weuse theirprocedure.within hoursof patient. Patients are often abletoreturn home lower mortality, andincreased comfort forthe catheterization bleeding, provides lessriskof When appropriate, transradial cardiac each patient.unique health status of depending onthespecificdeviceand catheter access—radial orfemoral— the siteof Throughout thesystem, ourspecialistsselect Leading thetransradial approach

Nauman Siddiqi, MD MD Peichert, B. David MD Kaliyadan, G. Antony John C. Wang, MD Baltimore region MD O.William Suddath, Toby Rogers,MD MD Raman, K. Venkatesh MD Katzen, M. Scott Hayder Hashim,MD MD Ginsberg, S. Eric Nelson L.Bernardo, MD Itsik Ben-Dor, MD MD Al-Omari, A. Malik MD Addala, Srinivas Ron Waksman,MD Lowell F. Satler, MD region Washington, D.C. physicians cardiology Interventional

7 CAPABILITIES PERFORMANCE OUTCOMES 8 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH Hospital Center MedStar Washington Interim Chief, Cardiac Surgery Christian Shults, MD Memorial Hospital MedStar Union Chief, Cardiac Surgery Michael Fiocco, MD | Cardiac Surgery

highlights Key and structural heart disease) nationally andinternationally. heart failure, LVAD implantation, transplantation, interventionalcardiology, (aortic disease management, vascularsurgery, electrophysiology, advanced They collaborate with subspecialistsacross the cardiovascular spectrum, and education. strongest volumesinthecountry, are leaders inprofessional societies, research, Our cardiac surgeons, thefinestoutcomesand inadditiontoproducing someof Cardiac surgery Read more aboutthesecollaborations andothersonthepagesthat follow. • • • • • • or complex aortic disease. Read more onpage10. referrals foremergent, urgent, andelectiveevaluation andtreatment any routine of Together withvascularsurgery, our The mitral regurgitation, currently underinvestigation inthe APOLLO trial. orthostatic tachycardia syndrome (POTS). ablation forthetreatment inappropriate of sinustachycardia (IST) andpostural hybrid procedures, includingconvergent procedures andadenovothoracoscopic We performcombinedendocardial andepicardial ablations andother theTendynesafety andefficacy of We are thesecondhighestenroller inthecountryforSUMMIT trial, testingthe We are amongthe as analternative toopen-heart surgery. busiest centersinthemid-Atlanticregion. Our team performed procedures Cardiac surgery 2,210

Intrepid ™ TMVR systemisanewoptionforpatients withsevere, symptomatic top 5centersinthecountryforLVAD implantation volumes. 29 heart transplantations in2020, the makingusoneof ™ Aortic Disease Managementprogram accepts transcatheter mitral valvereplacement system 198 procedures + AVRCABG complex complex

Compared 10.1% toSTS benchmarkof CABG readmission rates MedStar Washington HospitalCenter 7.2% awarded

MEDSTAR HEART & VASCULAR INSTITUTE Mitral valvesurgeries 172 | Cardiac Surgery Compared toSTS 3.2% average of Mortality formitral surgeries 2.2%  Hospital awarded MedStar UnionMemorial in theU.S. highest achievablemetrics Three starsrepresents the Coronary Artery Bypass Grafting CABG Thoracic Surgeons The Societyof Ricardo O. Quarrie, MD Brian T. Bethea, MD Michael Fiocco, MD Baltimore region Ezequiel J. Molina, MD Hiroto Kitahara, MD Jeffrey E. Cohen, MD Ammar S. Bafi, MD Christian C. Shults, MD region Washington, D.C. surgeons Cardiac  

of Technology.of Management at theMassachusetts Institute He holdsanMBA from theSloanSchool of the pasttenyears, Yale NewHavenHealth. Cleveland Clinic, Temple University, andfor Center prior tofacultyappointmentsat the surgery at Columbia UniversityMedical completed hisfellowshipin cardiac Brigham and Women's Hospital. He award-winning stemcellresearch at Health andpursued National Institutesof Service Award fellowshipfrom the received apostdoctoral National Research Hospital/Harvard MedicalSchool, he surgery at theMassachusetts General After completinghisresidency ingeneral medical degrees from Brown University. Dr. Mangiearned hisundergraduate and aorta andaortic arch replacement. repair andreplacement, andascending repair andreplacement, transcatheter valve cardiac surgery, aortic andmitral valve He specializesincomplex andre-operative System Integration andQuality. Surgery Network, andtheDirector of the Managing Director of Yale Cardiac New HavenHealth, where hewasalso Heart andCardiac Valve Program for Yale served asSurgical theStructural Director of across MedStar Health. Hemostrecently will lead thecardiac surgery programs Arriving thisspring, Abeel A. Mangi, MD, CardiacMedStar Health Chairof Surgery. Abeel A. Mangi, MD, named asnew

9 CAPABILITIES PERFORMANCE OUTCOMES 10 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH VALVE AORTIC ROOT AORTIC ARCH AORTA THORACIC DESCENDING AORTIC AORTA ASCENDING AORTA ABDOMINAL THORACO-

| Aortic Disease Management operating room toallowforbothopenandendovascularapproaches, aswellcontemporaneous imaging. collaborative assessmenttodeterminethepatient’s least invasive, mosteffective, solution. Procedures take placeinahybrid Patients benefit from ateam that istruly multidisciplinary, ledbycardiac andvascularsurgeons. Together,a theyperform availableoptions,with thefullspectrumof includingopen, minimallyinvasive, andtranscatheter approaches. than anyotherprogram intheregion. We treat themostcomplex cases—includingpatients whohavebeen deniedcare elsewhere— The aortic disease managementprogram thelargest inthemid-Atlanticandourteams isoneof performmore aortic interventions Aortic disease management Vascular surgeon SuzanneKool, MD, cardiac surgeon Ricardo Quarrie, MD, andvascularsurgeon Raghuveer Vallabhaneni, MD highlights trial Clinical • the aortic arch anddescendingthoracic aorta (TBE Device)forthetreatment lesionsof of OE TBE GORE® Thoracic Branch Endoprosthesis • aortic aneurysms and pararenal thoracoabdominal for thetreatment of Endoprosthesis Branch Thoracoabdominal OE TAMBE GORE®

• • system byEndologix sac management repair usingaortic aortic aneurysm aortic aneurysms thoracoabdominal pararenal, and juxtarenal, of IDE forrepair Physician-sponsored ChEVAS pararenal

AORTA INFRARENAL MEDSTAR HEART & VASCULAR INSTITUTE 58 elective procedures Ascending aortic Mortality rate 0% infrarenal repair aneurysm (AAA)elective Abdominal aortic Mortality rate 0% procedures elective Aortic root

| Aortic Disease Management Cardiac surgeon ChristianShults, MD, andvascularsurgeon Javairiah Fatima, MD Washington, D.C. region: 800-824-6814 Baltimore region: 410-554-2332 To refer apatient andarrange fora24/7transfer, call: We acceptalltransfers. Our MedSTAR Transport serviceprovides expedited airandground accesstocare, regardless patient location. of • Aneurysm dissection • Aortic Complex referral casesmayinclude: emergent, urgent, andelectiveevaluation andtreatment complex aortic disease. of Located at MedStar Washington HospitalCenter andMedStar UnionMemorialHospital, weoffer 24/7referral for ComplexCenters Aortic • Penetrating ulcer • Occlusion

• Otheraortic pathology • Intramural hematoma

11 CAPABILITIES PERFORMANCE OUTCOMES 12 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH MedStar Health Vascular Program Director Edward Y.Woo, MD

| Vascular Surgery

19 11 23

Locations Hospitals Surgeons The MedStar Health vascularprogram isthelargest intheregion andamongthemostsophisticated inthenation. Vascular surgery from themerely uncomfortable tothelife-threatening. Our diverseteam specializesinthediagnosisandtreatment allvasculardisorders, of from thecommontoesoteric, intervention. therapy and all varietiesof noninvasive laboratories, through screenings, to diagnosis inour beginning withcommunity PAD ismanagedat everystage, Peripheral arterial disease highlight trial Clinical

limb ischemia. associated withcritical arterial disease and in patients withperipheral optimal surgical therapy endovascular therapy to study comparingoptimal BEST-CLI: International International

<1% highlight Innovation for stenosis, tumor, andaneurysm. carotid disease, includingtreatment Our expertise coversthespectrumof Carotid artery disease procedure. Revascularization (TCAR) TransCarotid Artery thenovel in theuseof We are leading theregion stroke rates revascularization Carotid

our collaborations throughout aneurysms. Read more about thoracoabdominal aortic in patients withmore complex endovascular repair (F/B-EVAR) and fenestrated orbranched abdominal aortic aneurysms, EVARs inpatients withinfrarenal aneurysms anddissections, for patients withthoracic aortic including TEVARspathology We provide treatment forallaortic Aortic disease the aorta onpage10.

MEDSTAR HEART & VASCULAR INSTITUTE Virginia, and Washington, D.C. turnarounds. Services are nowavailableat ninelocations inMaryland, staffed withlicensedtechnologists whocanruntestsforfast, same-day underlying condition. Eachcenterhasanonsite, accredited vascularlab, comprehensive diagnosticsandtreatment amore serious intheeventof clinic, paired vascularsurgeons withtheexpertise who provide of These boutiquesettings offer aspecialty clientsthe comfort andluxury of to thetreatment venousdisease, of includingcosmeticandfunctional. MedStar Health Vein Centers are convenientoutpatient clinicsdedicated Cosmetic andvaricoseveins highlights Innovation and retained IVC filter. including acuteandchronic deepveinthrombosis, inferiorvenacavaocclusivedisease, We treat deepvenousdisease withopenandendovasculartechniques, allformsof Deep venousdisease • • treatment andreduced procedure times. subacute, andchronic clotswithsingle-session allows formore thorough acute, removal of ClotHunter We are the onlyprovider intheregion to are We syndrome. surgery totreat deepveinpost-thrombotic technique combiningopenandendovascular offer endovenectomy, aminimallyinvasive first in the world to use the first intheworldtouse ™

thrombectomy catheter, which | Vascular Surgery highlight trial Clinical Thrombectomy System. the vein thrombosis using lower extremity deep subacute, andchronic treatment acute, of registry (CLOUT) for ClotTriever Outcomes We are the part of ClotTriever ®

• • • • Medicare &MedicaidServicesnational standard is66percent. reducing infectionandloweringmortality. The Centers for Our prevalent arteriovenous fistula rate is70percent, thereby manage percutaneous fistulae, AV fistulae, andbypass grafts. complex optionstotreat dialysispatients withanarray of and reduced infectionandlong-term access, ourteam manages kidneydiseaserates intheUnitedStates. of With afocuson in themid-Atlanticregion, anareathehighest withsomeof We provide thelargest vascularhemodialysisaccessprogram Vascular accessprogram 2,500 for the option of homedialysis. for theoptionof veins orprevious stenosis. access cannotbeobtainedthrough thestandard route, duetoblocked this approach. This specializedgraft isapplicableforpatients inwhom the highestvolumesincountry. We alsoserveasaregional proctor for We specializein We are theregional leader in avoiding surgical incisions. EndoAVF System, atechnologyforpercutaneous fistulacreation, surgical procedure. patients whohavepoorveinsandare notcandidates forthestandard In somecases, weusethe Using Artegraft®, abovinetissuegraft, wecanobtainaccessfor state-of-the-art therapies, suchastheVenaSeal Our participation inclinicaltrialsaffords patients theoptionof permanently closediseased veins. non-tumescent, non-sclerosant closure systemusing adhesiveto highlights Innovation laparoscopic peritoneal catheter insertion, allowing highlight Clinical trial minimally invasive WAVELINQ™minimally cases annually Vascular access HeRO® graft placementsandhaveamong ™ , anon-thermal,

13 CAPABILITIES PERFORMANCE OUTCOMES 14 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH Vascular surgeons Stephen F. Stanziale, MD Suzanne S. Kool, MD Jason R. Crowner, MD Jason A. Chin, MD W.Maggie Arnold,MD Raghuveer Vallabhaneni, MD Baltimore region Kyle B. Reynolds, MD Mark O. Peeler, MD Krystal C. Maloni, MD Lucy B. Kupersmith, MD Misaki M. Kiguchi, MD Geetha Jeyabalan,MD Ayesha Hatch, MD John Harvey, MD Faris Z. Hakki, MD Jesse P. Garcia, MD Arthur Flatau, III, MD Javairiah Fatima, MD Joshua A. Dearing, MD Kevin A. Brown, MD Cameron M. Akbari, MD Steven D. Abramowitz, MD Edward Y.Woo, MD Washington, D.C. region | Vascular Surgeons and Locations 2 6 5 4 3 1 Baltimore P Annapolis, MD21401 2002 MedicalPkwy., Ste. 520 The VascularInstitute MedStar Health Cardiology Associates Annapolis Maryland P Washington, DC20010 Physicians Office Building South, Ste. 408 106 IrvingSt., NW Medical Association Hakki MedStar Washington HospitalCenter P Washington, DC20010 Physicians Office Building South, Ste. 419 106 IrvingSt., NW Vascular Access MedStar Washington HospitalCenter- P Washington, DC20010 Physicians Office Building North, Ste. 3150 106 IrvingSt., NW Center for Vascular Care MedStar Washington HospitalCenter P Washington, DC20036 1133 21stSt., NW, 7thFl. MedStar Health at Lafayette Centre P Washington, DC20007 Pasquerilla Healthcare Center, 4thFl. 3800 Reservoir Rd., NW MedStar Georgetown UniversityHospital Columbia District of Vascular program locations P Baltimore, MD21239 Smyth Bldg., Ste. 303 5601 Loch Raven Blvd. MedStar GoodSamaritanHospital P Baltimore, MD21237 9101 Franklin Square Dr., Ste. 212 MedStar Franklin Square MedicalCenter 410-571-8430F 202-877-5007F 202-877-3100F 202-877-0275F 202-416-2000F 202-444-2255F 443-444-3431 F 443-777-1900F

410-573-5981 949-437-2278 202-877-6585 202-877- 0456 202-416-2007 877-376-2434 443-444-3435 443-777-1901

14 13 12 11 10 7 8 9 Bel Air, MD21015 12 MedStar Blvd., Ste. 175 MedStar Health Bel Air MedicalCampus Bel Air P Baltimore, MD21218 Johnson Professional Building, Ste. 325 3333 North Calvert St. P Clinton, MD20735 7501 Surratts Rd., Ste. 208 Hospital Center MedStar SouthernMaryland Clinton P Chevy Chase, MD20815 5454 Wisconsin Ave., Ste. 1100 MedStar Health at ChevyChase Chevy Chase P Chester, MD21619 1630 MainSt., Ste. 208 Kent Island MedStar Health Cardiology Associates Chester P Charlotte Hall, MD20622 29955 Three NotchRd., Ste. 201 MedStar MedicalGroup at Charlotte Hall Charlotte Hall F P Bowie, MD20716 4175 North HansonCt., Ste 100 MedStar Health Cardiology Associates Bowie P MedStar UnionMemorialHospital F P P Baltimore, MD21225 Outpatient Center, Ste. 216 3001 S. HanoverSt. MedStar HarborHospital 410-554-2950F 301-877-7353F 301-215-9420F 410-643-3186F 240-434-4072F 301-809-6880or410-741-1835 443-777-1900F 410-350-3357(callcenter, front desk) 443-444-3431(scheduling) 301-805-4233 443-444-3435

410-261-8226 301-877-1240 301-215-4499 855-861-2080 240-434-4022 443-777-1901

20 19 18 17 16 15 F P McLean, VA22101 6862 ElmSt., Ste. 800 MedStar Health at McLean McLean Northern Virginia P Prince Frederick, MD20678 301 Steeple ChaseDr., Ste. 107 MedStar Health at Prince Frederick Prince Frederick P Pikesville, MD21208 1838 Greene Tree Rd., Ste. 245 at Pikesville MedStar Health Vascular Surgery Pikesville P Olney, MD20832 18109 Prince PhilipDr., Ste. B-100 MedStar Montgomery MedicalCenter Olney P Leonardtown, Md. 20650 Outpatient Pavillion, Ste. 200 25500 Point Lookout Rd. MedStar St. Mary’s Hospital Leonardtown P Hollywood, MD20636 24035 Three NotchRd., 2ndFl. Cardiology Shah Associates Hollywood 703-288-7070, Option#5 410-535-7290F 410-554-2950F 301-774-8962F 240-434-4072F 301-373-7720F 866-990-5516 410-535-7291 410-261-8226 301-774-8963 240-434-4022 301-373-6700

81 Hagerstown

70 81 MEDSTAR HEART & VASCULAR INSTITUTE Walkersville Hagerstown Manassas 66 Frederick Leesburg 7 70 Germantown Gaithersburg Lansdowne Clarksburg Reston Fairfax 20 Walkersville Manassas 2 270 Potomac 66 Frederick Leesburg Mt. Airy Annandale 95 7 McLean Damascus Union Bridge Germantown Rockville 13 Gaithersburg 1 Lansdowne Clarksburg Reston Chase Chevy Fairfax 20 17 Olney

Fort Washington 2 270 Mt. Vernon Potomac 395 70 Alexandria Groveton Mt. Airy Annandale 95 McLean Damascus University Hospital MedStar Georgetown Union Bridge Hospital Center MedStar Washington Colesville Rockville Medical Center MedStar Montgomery Cloverly 13 1 Hyattsville 3 St. Charles Chase Chevy 301 17 Olney

Fort Washington Mt. Vernon 395 495 70 Westminster La Plata Alexandria Groveton WASHINGTON, D.C. | University Hospital MedStar Georgetown White Plains Hospital Center MedStar Washington Colesville Eldersburg BALTIMORE Waldorf Clinton Medical Center MedStar Montgomery Cloverly 14 Vascular Program Locations 495 Hyattsville Greenbelt 3 Columbia St. Charles 301 Suitland 495 1 Westminster La Plata WASHINGTON, D.C. White Plains Hospital MedStar St. Mary’s Eldersburg BALTIMORE Waldorf Randallstown Clinton 14 495 Brandywine Greenbelt Columbia Laurel Hampstead Suitland Hospital Center MedStar SouthernMaryland 1 Charlotte Hall Hospital MedStar St. Mary’s 95 100 Randallstown Hospital MedStar Harbor

32 Brandywine Laurel Hampstead 795 Mitchellville Palmer Park Bowie Hospital Center MedStar SouthernMaryland Charlotte Hall Hughesville Elkridge 95 100 Arbutus Mills Owings Hospital MedStar Harbor

32 5 18 795 Mitchellville Palmer Park Bowie Hughesville 695 Elkridge Pikesville Meade Fort Arbutus Mills Owings 5 18 Odenton 695 Pikesville Meade Fort Odenton 10 10 11 11 Marlboro Upper Marlboro Upper 7 8 7 8 83 83 Leonardtown 83 6 Leonardtown 83 4 6 Cockeysville 4 Cockeysville 19 19 Towson 16 97 2 Huntington Park Brooklyn Towson 16 Beach Chesapeake Burnie Glen Samaritan Hospital MedStar Good 97 895 695 Frederick Prince 2 Huntington Park Brooklyn Memorial Hospital MedStar Union Beach Chesapeake Burnie Glen Samaritan Hospital MedStar Good 895 Deale 695 Hollywood California Frederick Prince Severna Park Overlea 695 Memorial Hospital MedStar Union Annapolis 15 Side Shady Dundalk Perry Hall 4 Jarrettsville Lexington Park Deale Arnold Hollywood California Severna Park Overlea 695 5 Annapolis 15 Essex Side Shady Dundalk Rossville Perry Hall 4 Edgemere Jarrettsville Lexington Park Arnold 50 9 Joppatowne 1 5 Square MedicalCenter MedStar Franklin White Marsh Essex Nottingham Rossville Edgemere Bel Air Kent Island 50 9 Chester Joppatowne 1 12 Square MedicalCenter MedStar Franklin White Marsh Aberdeen Nottingham 95 Bel Air Kent Island 40 Chester 12 Aberdeen 95 50 Cambridge 40 Salisbury 50 Cambridge Salisbury 15 CAPABILITIES PERFORMANCE OUTCOMES 16 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH MedStar Health Cardiac Electrophysiology Director Zayd A. Eldadah, MD, PhD

| Cardiac Electrophysiology 19 23 Electrophysiologists Locations

distinguish thisprogram. referring physicians. High-volume experience andconcentrated expertise, coupledwithstate-of-the art technology, technical procedural care alongwithlongitudinaloutpatient managementinconcert our withandinsupport of We heart rhythmconditionsandare managethefullspectrumof theregion’s leading referral center, offering highly Washington, D.C., and Virginia. and mostgeographically expansive EPservicelinesinthecountry, with23convenientlocations inMaryland, ourpatients,rhythm care foreverysingleoneof closetohomeandwork. MedStar Healththelargest offers oneof CardiacThe Sectionof Electrophysiology (EP)aimstoprovide comprehensive, cutting-edge, personalizedheart Cardiac electrophysiology 563 programs forthisdevice. country’s highestvolumeimplantation to implantit. Today, weare amongthe and wasthefirstinstitutionin region appendage occluderover15years ago of theoriginal WATCHMANof MedStar Health pioneered development WATCHMAN ™ to date procedures WATCHMAN

left atrial

1,637 technology. highest-volume experts employingthis and continuetobeamongthecountry’s cryoballoon ablation foratrial fibrillation contributed tothedevelopmentof Our cardiac electrophysiologists also Cryoablation ablations Cardiac highlights Innovation on complex hybridprocedures. electrophysiologist Athanasios Thomaides, MD, collaborate MEDSTAR HEART & VASCULAR INSTITUTE (l tor)Cardiac surgeon ChristianShults, MD, and • • We collaborate withcardiac surgeons for conditions. underdiagnosed andoften untreated other treatments forthesehistorically option topatients whohaveexhausted groundbreaking treatment offers anew tachycardia syndrome (POTS). This tachycardia (IST) andpostural orthostatic for thetreatment inappropriate of sinus nation, tooffer thoracoscopic ablation the region, andamongonlyseveninthe procedures. Mostrecently, wewere firstin ablations andothercomplex hybrid combined endocardial andepicardial  attempt(s) at LV lead implantation. world whohavehadpriorunsuccessful regularly treats patients from alloverthe Resynchronization Therapy, andhe his methods, InterventionalCardiac (LV) lead implantation. Hehastermed transvenous leftthe successof ventricular and techniquestofacilitate andoptimize personally developedspecializedtools internationally recognized senior consultant, Seth Worley, MD, (pictured below)an | Cardiac Electrophysiology

Baltimore region Glenn Meininger, MD, director, cardiac electrophysiology, highlights trial Clinical

of devicesandapproaches,of includingtheserecent highlights: field, ourteam continuestoplayacritical role inthedevelopment As aninternationally recognized contributortoadvancesinthe • • • • • • • occlusion systems,includingthe AMPLATZER Testing thelatest theeffectiveness of and Coherexand WaveCrest of theheart andveins. of defibrillation therapy isdelivered byalead placedoutside boom placement, andmappingequipment. resolving issuesincludingfluoroscopy software, surgical lighting, to Family Heart, Vascular, and Thoracic Institute, weworked closely Harnessing ourpartnership withtheClevelandClinic’ an Ongoing studyof with theWATCHMAN FLX OPTIONS study, whichcompares left atrial appendageclosure Enrolling theworld’s patients as oneof select centersinthe of theVASCADE®of vascularclosure device. national principalinvestigator (PI)siteforamulti-centerstudy Pioneering same-daydischarge after catheter procedures as following catheter ablation. country’s highestenrollers intheHELIOSTAR andSTELLAR trials. catheters forthetreatment the atrial fibrillation asoneof of Testing damage tosurrounding tissue. selectivity, sharplyreducing thepotentialforunintentional enables pulmonaryveinisolation withgreater efficiency and therapy for AFib byelectroporation. This noveltechnology Launching trials of Launching trialsof redesign theEPLabsat MedStar UnionMemorialHospital, novel multi-electrode radiofrequency balloon pulsed fieldablation, anext-generation extravascular ICDsystem,inwhich ™ . ™ as an alternative to anticoagulation asanalternative toanticoagulation left atrial appendage ™ Amulet experience with left atrial appendage occlusion systems. atrial appendage occlusion systems. experience left with high-volume with globally physicians of group select and asmall among are MD, Lee, Sung (below) and MD, Strouse, David MD, Shah, Manish MD, Durrani, r)(l to Sarfraz s Miller s Miller ™

17 CAPABILITIES PERFORMANCE OUTCOMES 18 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH physicians electrophysiology Cardiac Sunjeet S. Sidhu, MD Malick Islam, MD Rafique Ahmed, MD Glenn R. Meininger, MD Baltimore region Seth J. Worley,MD Allison C. Warren, MD Athanasios Thomaides David A. Strouse, MD Manish H. Shah, MD Edward V. Platia, MD Susan O. O’Donoghue, MD Jay A. Mazel, MD Sung W. Lee, MD Cyrus A. Hadadi, MD Michael S. Goldstein, MD Margaret B. Fischer, MD Sarfraz A. Durrani, MD WalterL. Atiga Zayd A. Eldadah, MD, PhD Washington region | , MD Cardiac Electrophysiologists and Program Locations , MD Cardiac electrophysiology program locations electrophysiology Cardiac 2 7 6 5 4 3 1 P Washington, DC20010 Physicians Office Building North, Ste. 4800 106 IrvingSt., NW North TowerPOB MedStar Washington HospitalCenter P Washington, DC20010 110 IrvingSt., NW, Ste. 5A-12 MedStar Washington HospitalCenter P Washington, DC20036 1133 21stSt., NW, Ste. 700 at Lafayette Centre MedStar Health Cardiology Associates P Washington, DC20007 Pasquerilla Healthcare Center, 5thFl. 3800 Reservoir Rd., NW MedStar Georgetown UniversityHospital P Baltimore, MD21239 5601 Loch Raven Blvd., Ste. 206 MedStar GoodSamaritanHospital P Baltimore, MD21237 9105 Franklin Square Dr., Ste. 306 MedStar Franklin Square MedicalCenter Baltimore P Annapolis, MD21401 2002 MedicalPkwy., Ste. 500 MedStar Health Cardiology Associates Annapolis Maryland P Baltimore, MD21225 3001 S. HanoverSt., Ste. 206 MedStar HarborHospital District of Columbia District of 410-544-6727 202-877-5800F 202-877-7685F 202-416-2000F 202-444-8843F 410-544-6727F 410-573-6480F 410-544-6727F F

410-554-2044 202-877-5885 855-430-5304 202-416-2007 877-303-1461 410-554-2044 410-573-9413 410-554-2044

14 13 12 11 10 8 9 F P P P Hagerstown, MD 21740 1733 HowellRd. Hagerstown MedStar Health Electrophysiology Hagerstown F P P P Frederick, MD21702 163 Thomas Johnson Dr., Ste. E Frederick MedStar Health Electrophysiology Frederick P Ellicott City, MD21163 9501 Old Annapolis Rd., Ste. 308 Ellicott City MedStar Health Electrophysiology Ellicott City P Clinton, MD20735 7501 Surratts Rd., Ste. 304 Hospital Center MedStar Southern Maryland Clinton P Chester, MD21619 1630 MainSt., Ste. 208 MedStar Health Cardiology Associates Chester P Cambridge, MD21613 505 ByrneSt. MedStar Health Electrophysiology Cambridge P Baltimore, MD21218 Johnson Professional Building, Ste. 650 3333 North Calvert St. MedStar UnionMemorialHospital 202-877-7685–Dr. O’Donoghue 301-877-5677–Dr. Lee 703-208-7257–Drs. Atiga, Fischer 301-877-5677–Dr. Lee 202-877-7685–Drs. Eldadah, Shah 703-208-7257–Drs. Atiga, Fischer 410-554-6727F 301-877-5677F 410-643-3186F 202-877-3205F 410-554-6727F 855-374-5342 855.430.5304

410-554-2044 410-554-2044 855-384-5344 410-643-4098 855-430-5304 410-554-2044

20 19 18 17 16 15 P Lansdowne, VA20176 44084 RiversidePkwy., Ste. 150 Lansdowne MedStar Health Electrophysiology Lansdowne F Fischer P P Fairfax, VA22031 3020 Hamaker Ct., Ste. 502 MedStar Health Electrophysiology Fairfax Fairfax Virginia F P P Wheaton, MD20902 Georgia11915 Ave. Wheaton Urgent Care MedStar Health Electrophysiology Wheaton P Waldorf, MD20603 10 St Patricks Dr. Waldorf MedStar Health Electrophysiology Waldorf P Olney, MD20832 18109 Prince PhilipDr., Ste. 4100 MedStar Montgomery MedicalCenter Olney P Hollywood, MD20636 24035 Three NotchRd. Hollywood MedStar Health Electrophysiology Hollywood 202-877-7685F 703-208-7257–Drs. Durrani, Strouse, 202-877-7685–Dr. Eldadah 301-877-5677–Dr. Lee 202-877-7685–Dr. Eldadah 202-877-7685 301-570-7404F 301-877-5677F 855-374-5342 855-384-5344

F 855.430.5304 855.430.5304 855.430.5304 301-570-7405 301-877-5680

21 22 23 MEDSTAR HEART & VASCULAR INSTITUTE F P F P Reston, VA20190 Ste. 405 1830 Town Center Dr. Electrophysiology MedStar Health Reston F P Manassas, VA20110 8640 SudleyRd., Ste. 302 Manassas Electrophysiology MedStar Health Manassas F P Leesburg, VA20175 Ste. 306 224D Cornwall St. Cornwall Electrophysiology MedStar Health Leesburg 202-877-7685–Dr. Shah 703-208-7257–Dr. Atiga 703-208-7257 202-877-7685 855.430.5304 855-374-5342 855-374-5342 855.430.5304

Reston

81 | Hagerstown Cardiac Electrophysiology Program Locations 14 70 Manassas Walkersville 13 22 Leesburg 66 Frederick 7 23 Germantown 21 Lansdowne Gaithersburg Clarksburg Fairfax Reston Wheaton 270 2 20 Mt. Airy Annandale 95 19 Damascus McLean Union Bridge Rockville 18 1 16 Olney

Fort Washington Mt. Vernon 395 70 Alexandria Groveton University Hospital MedStar Georgetown Hospital Center MedStar Washington Colesville Medical Center MedStar Montgomery Cloverly 3 Hyattsville St. Charles 301 495 Westminster La Plata WASHINGTON, D.C. White Plains BALTIMORE Eldersburg Waldorf Clinton City Ellicott 11 495 Greenbelt Columbia Suitland 12 1 Randallstown Brandywine Laurel Hampstead Hospital Center MedStar SouthernMaryland 17 Charlotte Hall 95 100 Hospital MedStar Harbor

32 Reisterstown 795 Bowie Mitchellville Palmer Park Hughesville Elkridge Arbutus Mills Owings 5 695 Meade Fort Odenton Crofton Marlboro Upper 7 8 83 Leonardtown 83 6 4 Cockeysville Hollywood Towson 97 2 Huntington Park Brooklyn Beach Chesapeake Burnie Glen Samaritan Hospital MedStar Good 895 695 Frederick Prince Memorial Hospital MedStar Union Deale California Severna Park Overlea 695 15 Annapolis Side Shady Dundalk Perry Hall 4 Jarrettsville Lexington Park Arnold 5 Essex Rossville Edgemere 50 Joppatowne 1 Square MedicalCenter MedStar Franklin White Marsh Nottingham Bel Air Kent Island Chester 10 Aberdeen 95 40 9 50 Cambridge Salisbury 19 CAPABILITIES PERFORMANCE OUTCOMES 20 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH Chart 1Option MedStar Health Advanced Heart Failure Director Samer S. Najjar, MD

Observed/expected ratio 1.00 .20 .40 .60 .80 HEART FAILURE MORTALITY INDEX 0

| Advanced Heart Failure 2016 .88

2017 .93 2018 .82 2019 .59 • • • • • A dedicated cardiogenetics specialist(more onpage25) our system. Ourpatients haveaccessto: This program intersectswithothersubspecialtiesacross precludes themfrom receiving care at othercenters. whose casecomplexity oradvanceddisease state support, andheart transplantation—often forpatients We offer advanceddrugtherapy, mechanicalcirculatory to patients. bringing sophisticated disease managementcloser regional coverage across hospitalsandoutpatient clinics, program inthearea, ourmultidisciplinaryteam provides As themostcomprehensive advancedheart failure Advanced heart failure for patients withend-stagedisease cardiopulmonary stress testing management andfamilysupport (more onpage26) Palliative care planning, embeddedwithsymptom home-based, Delivery of Early identification anddiagnosisthr Pulmonary hypertension expertise     Chart 2Option 1000 2000 3000 4000 5000 6000 7000 8000 4620 Y6F1 Y8F1 FY20 FY19 FY18 FY17 FY16 CLINIC VOLUMES intravenous, inotropic drugs, 5090 5797

ough specialized ough specialized 6569 6925

and MedStar HarborHospital MedStar UnionMemorialHospital, MedStar GoodSamaritanHospital, George Ruiz, MD, Cardiology of Chief • • Nursenavigators • • Hospitalists • Intensivists • professionals participate, including: each patient’s care.details of planof More than75 Our multidisciplinaryteam meetsweeklytodiscuss  VAD andtransplant coordinators providers pr Advanced  cardiothoracic surgeons Cardiologists and actice actice • Socialworkers • Palliative care specialists • Medicalethicists • Nutritionists • Pharmacists • •

health nurses   occupational therapists Physical and Clinic andhome

Program Director, Hypertrophic Cardiomyopathy MEDSTAR HEART & VASCULAR INSTITUTE patients failure for heart therapies of Full range Sandeep Jani, MD(center) Program Director, Infiltrative Cardiomyopathy Farooq Sheikh, MD

Prescription medications Prescription

| Advanced Heart Failure agents Intravenous inotropic cardiogeneticscounselor. cardiologists, cardiac surgeons, anda experts, electrophysiologists, interventional disease. The team includesimaging require specializedcare forthiscomplex long-term treatment planforpatients who provides diagnosesandanindividualized, Our hypertrophic cardiomyopathy clinic Hypertrophic cardiomyopathy and challengingforms:cardiac sarcoidosis andcardiac amyloidosis. infiltrative cardiomyopathy,all formsof themostcommon includingtwoof We are theregion’s premier program fordiagnosesandmanagementof Infiltrative cardiomyopathy highlights trial Clinical • • options that canmean thedifference betweenlifeanddeath forpatients: Innovative newmedications andphase3clinicaltrialsmaynowoffer treatment amyloid cardiomyopathy (ATTR-CM). (ION-682884) compared toaplaceboinpatients withtransthyretin-mediated cardiomyopathy (ATTR amyloidosiswithcardiomyopathy). Vutrisiranand safetyof inpatients with transthyretin amyloidosiswith In In CARDIO-TTRansform, HELIOS-B, aworldwide, multicenterstudy, weare evaluating theefficacy support circulatory Mechanical

we are investigatingAKCEA-TTR-LRx theuseof Heart transplantation Heart W. Xu, David MD MD Krishnan, Mrinalini MD Jani, M. Sandeep Tolu MD Agunbiade, A. MD Ruiz, George Baltimore region MD Sheikh, H. Farooq MD Rodrigo, E. Maria Rao, MD Sriram Ezequiel J. Molina, MD MD Lam, Phillip H. Hiroto Kitahara, MD MD Kadakkal, Ajay Hofmeyer, MD R. Mark MD Brown, R. Jennifer Najjar, S. MD Samer region Washington, D.C. physicians failure heart Advanced

21 CAPABILITIES PERFORMANCE OUTCOMES 22 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH 700+ TOP 5 VAD andHeart Transplantation Surgical Director Ezequiel J. Molina, MD in thecountry VADimplants of with highestvolumes Among thetop5centers | Chart 3 VentricularDevices Assist

Number of Implants

30 60 90 0

to date to date implanted VADs Chart 3 052016 2015 67

63 Number of Implants highlights Innovation patients has grown continuouslywith multipledevicesandsuperiorsurvivalrates foreventhemostcritical, highlycomplex In 1988, thefirstcentersinworldtoimplantaventricularassistdevice(VAD). webecameoneof The program Ventricular assistdevices 30 60 90 0 Chart 3 2017 83 Chart 3 052016 2015 67 2018 88 —those whoare of ­

Number of Implants 30 60 90 63 2019 79 0 Number of Implants • • • • 30 60 90 2017 circulatory support. VAD implantation acutemechanical after aperiodof can bestabilized, openingthepotentialfordurable program, Through arobust with ourelectrophysiology colleagues. post-LVAD arrhythmiasthrough acollaboration the criticalmedicalandsocialcare needed. patients withminimalfamilysupport byproviding risk of rightventricularfailure. risk of shorter ICUandhospitalstays, andpossiblyreduced results inlessbleedingandneedfortransfusions, SWIFT trialwiththeHeartMate 3LVAS. The approach this approach continuethrough participation inthe through aminimallyinvasivetechnique. Studies of implantations are 80% of currently performed Coming soon, wewillexplore Our 83 0 052016 2015 67 VAD lonertrack facilitates treatment for HeartMate-II HVAD HeartMate-3 2018 88 052016 2015 63 67

patients presenting withcardiogenic shock ten deniedtreatment at othercenters. 2019 79 2017 83 63 VAD IMPLANTS ECMO and Impella 5.0/5.5 ECMO andImpella5.0/5.5 2018 88 2017 83 HeartMate-II HVAD HeartMate-3 2019 79 2018 88 ways to reduce ways toreduce 2019 79 HeartMate-II HVAD HeartMate-3 2020 82

HeartMate-II HVAD HeartMate-3

Chart 4

Shaded areas indicate 70% confidence limits p (log-rank) = 0.0709 Percent Survival (%)

100

90 80 70 60 50 40 30 20 10

0

3 9 2 5 8 1 4 7 0 3 6 9 2 5 8 1 4 7 60 57 54 51 48 45 42 39 36 33 30 27 24 21 18 15 12 9 6 3 0 June 23, 2006toSeptember30, 2020 POST IMPLANT SURVIVAL

Months After Device Implant (n =431, Deaths =134) MedStar Washington HospitalCenter STS Intermacs(n=29436, Deaths =10483) Chart 7 MEDSTAR HEART & VASCULAR INSTITUTE Heart Transplantation Medical Director Maria E. Rodrigo, MD

Rate per 100-Person Years January 2018toDecember2019 10 ADULT WAITINGLIST 0 2 4 6 8 MORTALITY RATES Observed 5.0

Expected 6.9

| Heart Transplantation Chart 6

One-year Survival (%) HEART TRANSPLANTATION ONE-YEAR SURVIVAL 2019 2018 2017 2016 2015 2014 highlights Innovation goal of offering thislife-savingproceduregoal of tomore patients. 1987, weremain committed toexpanding ourprogram withtheultimate Since performingthefirstheart transplantation in Washington, D.C., in Heart transplantation 1 2 3 4 5 6 7 8 9 100 90 80 70 60 50 40 30 20 10 0 • • • from further distances. opportunities fortransplantation donorhearts byallowingretrieval of without damagetotheorgan. This provides ourpatients withgreater adonorheartSystem, maybeextended theischemicwindowof Through the ouruseof 15 percent peryear. transplantable heartsthat thenumberof mayincrease bymore than without anadverseimpactonrecipient outcomes. The expectation is We thefive areregional heart oneof transplant programs We are abletotransplant hearts from to non-invasivelyassessrejection obviating theneedforbiopsy. participating inanNIHresearch project toevaluate novelmethods Paragonix SherpaPak™ Cardiac Transport since 1987 Heart transplants 350+ 88% 89% 92% 94% 100% 100% Hepatitis Cpositivedonors

Chart 5Option

Number of Heart Transplants 10 15 20 25 30 HEART TRANSPLANTATIONVOLUMES 0 5

0421 0621 082019 2018 2017 2016 2015 2014 12

16 and families. among providers, recipients, virustransmission risk of were taken tominimizethe Extraordinary precautions between March andMay. 13 heart transplantations performed arecord-breaking Washington HospitalCenter our team at MedStar cardiovascular surgeries, many hospitalshadtolimit 2020, In thespringof as pandemic. COVID-19 onset of transplantations during Record heart numberof 18 18 16 16

2020

29

23 CAPABILITIES PERFORMANCE OUTCOMES 24 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH Medical Center MedStar Franklin Square Chief, Cardiology Sriram Padmanabhan, MD Cardio-Oncology Director, MedStar Health Ana Barac, MD, PhD subspecialty detailedinthisreport, aswelltheuniqueprograms highlightedhere. For more than60years, wehaveserved asamajorreferral sitelocally, across themid-Atlanticregion, andthecountry. Ourproviders are embeddedineach and screenings, orcomplicated treatment theveryill. of Across ouracutecare hospitalsandadvancedoutpatient clinics, cardiologists delivercomprehensive, integrated care toourpatients—whether forprevention Clinical cardiology andspecialtyprograms | Clinical Cardiology andSpecialty Programs

Cardio-Oncology Program Director, Baltimore Tolulope A. Agunbiade,MD MedStar HarborHospital MedStar GoodSamaritanHospital MedStar UnionMemorialHospital Chief, Cardiology George Ruiz, MD

Washington, D.C. region: Oncology Patients. the JACC: Shealsoisanassociate editor of CardioOncology. from the 2015to2019andisthedirectorACC of Livecourse on Advancing Cardiovascular Care in the Cardiology’sAmerican Collegeserved asthefoundingchair of of newCardio-Oncology Council protocols that are compatible withevolving oncologicapproaches. Ana Barac, MD, PhD, director, participating inprogressive research todevelopnewcardiovascular diagnosticandtreatment From the program’s initiation in2012, wehavebeenanational leader inthisfield, pioneeringand treatment planbefore, during, andafter apatient's cancertreatment. on heart function. Ourmulti-siteconsultative practice canestablishacomprehensive cardiovascular We are committed tosupporting effective methodsforfightingcancerwhileminimizing theimpact disease, andmore. failure, coronary artery disease, heart rhythmdisorders, peripheral vasculardisease, valvular heart new cancertreatments, cardiovascular complications cancontributetoanumberof includingheart morbidity andmortality inpeoplewithcancer. Chemotherapy andradiation therapy, alongwith Cardio-oncology isamedicalsubspecialtydedicated cardiovascular tominimizingtheeffects of Cardio-oncology Hospital Center MedStar SouthernMaryland Chairman, Cardiology William O. Suddath, MD 202-360-6367; Baltimore region: 877-452-0725

MedStar Georgetown UniversityHospital MedStar Washington HospitalCenter Chairman, Cardiology J.Allen Taylor, MD MEDSTAR HEART & VASCULAR INSTITUTE | • follow-up closetohome. D.C. Our89providers are availableat thesesites, allowingforstreamlined outpatient setting throughout Maryland, Northern Virginia, and Washington, MedStar Health ambulatory servicesexpands cardiovascular expertise tothe Ambulatory cardiology practices • • • a specialistappointment. cardiologist within24hours, avoidingthedelayassociated withobtaining emergency department andreceive rapid discharge withfollow-upbya As part of our As part of A core cardiologists group are of standardizing cardiovascular screening outpatient settings asappropriate. genetics. The team effectively transitions patients betweeninpatient and care may includeissuesrelatedof topregnancy, cancertreatment, and and treatment through thewomen’s heart health rehabilitation totreat thedisease. anyuniqueandlingeringeffects of cardiac screenings, multidisciplinaryclearances forreturn-to-work, and recovery program. Patients COVID-19 withahistoryof canreceive for patients. image-sharing systemsintoourpractices, further expanding convenience e integrate We We are at theforefront guidelinecreation of inour Clinical For aconsultation, please call hypercholesterolemia. dilated cardiomyopathy, Brugadasyndrome, andfamilial transthyretin amyloid, Long QT, hypertrophic cardiomyopathy, patients, includingparticularly complicated diagnosessuch as provide early detectionandinsightsintooptimaltreatment for genetic counselor, works across cardiovascular subspecialtiesto patients andtheirfamilymembers. MonishaKisling, Our cardiogenetics practice offers genetictestingandcounselingto Cardiogenetics

Cardiology andSpecialty Programs telehealth, remote monitoringprograms, andregional Urgent Heart program, patients canbetriagedinthe 202-877-GENE (4363). program. Nicheareas post-COVID ourdedicated

Baltimore region Chief,Services Ambulatory George D. Bittar, MD Washington, D.C. region Chief,Services Ambulatory Robert A. Lager, MD 25 CAPABILITIES PERFORMANCE OUTCOMES 26 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH For aconsultation, please call410-554-2201. Swimming, tohelp theathletes maximizetheir performance. Baltimore Orioles, Baltimore Ravens, Washington Capitals, andUSA conditions. Dr. Shahalsoworks withprofessional teams suchasthe provides each athlete withpersonalizeddata andinsightintopotential We offer specialized cardiopulmonary exercise testing, which • • • The program focuseson: sports medicine, histraining tiesthetwodisciplinestightlytogether. nation. With onefootfirmlyplantedincardiology andtheotherin Hospital sports cardiology fellowshipprogram director Ankit Shah, MD, theMassachusetts isagraduate General of programs inthenation tofocusonheart disease intheathlete. Our MedStar Sports &Performance Cardiology thefewformal isoneof Sports andPerformance Cardiology Ankit B. Shah, MD, Director, MedStar Sports &Performance Cardiology Assisting topathletes enhancecar among athletes myocarditis, myocardial infarction, andotherseriousheart conditions Helping "weekend warriors"andpr Preventing sudden, unexpected cardiovascular-related death   | Clinical

Cardiology andSpecialty Programs diovascular performance ofessionals return toplayafter —the only one in the —the onlyoneinthe ­

Baltimore region: 410-554-6550 Washington, D.C. region: 202-877-2339 and theirfamiliesincopingwiththiscomplex disease. with thePulmonary Hypertension Association toprovide support topatients trials, wecanoffer uniquetherapy optionstoour patients. We workclosely Health PHprogramNational Institutesof andparticipation inotherclinical to treating chronic thromboembolic PH. Through ourpartnership withthe access tolungtransplantation andotherspecialized surgery applicable We collaborate withotherinternationally recognized programs toprovide advanced therapy—prostacyclin infusion. PH, managementoptionsincluding themost forms of plusthefullrange of Our PHprogram offers comprehensive all evaluation anddiagnosisof remains poor. 14FDA-approved(PH) andtheavailabilityof medications totreat it, survival pulmonaryhypertension Despite majoradvancesinourunderstandingof Pulmonary hypertension Director, MedicalCardiovascular IntensiveCare Unit Christopher F. Barnett, MD, Director, Pulmonary Hypertension Program

For more information, call443-444-5993. We acceptreferrals from anyhospitalsystem. reduce hospitalreadmissionsstay. andlengthof These servicesworktogethertoimprove life, patient health andqualityof and upon hospitaldischarge. offer free membershiptotheon-sitegym. We alsoset up homehealth services to mentalhealth providers andsupport groups, helpwithtransportation, and life-long care. We address economicandnutritionalbarriers, connectpatients The team managespatients quicklyandtemporarily, adhoc, orforlong-term, lymphedema clinic, aclinicalpharmacist, dietitian, andmentalhealth support. all offered at theCenter. Also onsiteare cardiac andpulmonaryrehab, a and otherimagingmodalities, ultrafiltration, andamyloidosisworkups are IV medications, same-visitlab work, coordination withinterventionalradiology patients withheart failure through themyriadservicesinoutpatient setting. The GoodHealth Center at MedStar GoodSamaritanHospital manages The GoodHealth Center readmission rate MEDSTAR HEART & VASCULAR INSTITUTE Compared to24%hospitalsnotusingclinic to aMedStar Health hospital 6%

30-day 30-day

| Clinical

Cardiology andSpecialty Programs

in length of stayforhospitalizations in lengthof day decrease 5.2

pioneered thispersonalizedandholisticapproach. patient care.an essentialelementof We are proud to have palliative careof intoheart failure treatment inparticular, is symptoms.for care andmanagement of This fullintegration to support patients and theirfamilies, andtoco-managegoals These specialistsare embeddedinourmultidisciplinaryteams developingpatient careof planswhenclinicallyappropriate. Palliative care specialistsare alwaysbrought intotheprocess Palliative care 27 CAPABILITIES PERFORMANCE OUTCOMES 28 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH Medical andsurgical specialistsacross MedStar Heart & Vascular Instituterely oncardiovascular imaginginthediagnosisandtreatment patients. of Cardiovascular imaging If youhaveanimageyou’dlike todiscuss,If youmayuploaditto collaboration withresearchers andcliniciansfrom Health further theNational advancesourcapabilities. Institutesof Our patients sophisticated alsobenefitfrom andappropriate theuseof imagesindeterminingtheirrisks andimproving theiroutcomes. Ourlong-term | Cardiovascular Imaging images annually and cardiac CT Cardiac MRI 3,500 MedStarImageShare.com (TEE) annually echocardiograms Transesophageal 1,200

or call

202-877-5975.

(TTE) annually echocardiograms Transthoracic 13,200

Siemens MAGNETOM MEDSTAR HEART & VASCULAR INSTITUTE • • • Intelligentautomation • Reduced contrast dosing • Significantlylower radiation dosing • Siemens DualSource CT scannerSOMATOM Expanding uponprevious imagingabilities, thenewThome Advanced Cardiovascular ImagingCenter at New cardiovascular imagingoptions locations, andfewer test duplications. Patients quicker turnaround havethebenefitof times, flexible testing be located. themostexperienced readers,images inthehandsof wherever theymay specialists, andprovides information thefree byputting studiesand flowof The technologyenhancesreal-time collaboration among ourcardiovascular available toourcliniciansanywhere intheirrespective regions. where patients undergo atestwithinMedStar Health. Their results willbe Secure digitalrepositories houseallechocardiogram data regardless of Echocardiography inthecloud This state-of-the-art scannerprovides: • Larger magnetbore for increased patient comfort de novoapplications andelevates MRIcapability, plus: This new, recently approved scannerplatform delivers reducing theirneedtotravel. may havetheirimagingcompletedat MedStar UnionMemorialHospital, andread at MedStar Washington, MedStar Washington HospitalCenter provides pioneering cardiac imaging technology. Baltimore-area patients technically challenging cases technically challengingcases technically challengingsituations (e.g., arrhythmia) Faster sequencestosupport improved imaging in More accurate scanning, especially in Higher temporal r esolution at fasterheart rates ® Sola1.5T MRI | Cardiovascular Imaging

® Force

HeartFlow • A reduction inunnecessary catheterization • Advanced tissuecharacterization • • • • evaluation of coronaryevaluation stenoses, of providing: New software offers visualization andphysiologic for MRangiography prior to intervention prior tointervention for advanced cardiac MRI for advancedcardiac MRI and stenoses and stenoses Greater operator perspectiveand planning More accurate coronary evaluation anatomy of Stronger collaboration withtheNIH/NHLBI Expanded non-contrast andcontr ® FFR

CT Analysis ast technique ast technique

29 CAPABILITIES PERFORMANCE OUTCOMES 30 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH We provide post-operative care forthosewhohaveundergone surgical procedures, alongwithcardiac medicalconditionsandtreatments. In keeping withouroverall mission, ourcardiovascular criticalcare servicecontinuestomeettheincreasingly ourpatients. complex needsof Cardiovascular criticalcare | Cardiovascular Critical Care • 24/7familyvisitation isencouraged • In-house training andcontinuingeducation • • Holistic, family-focusedcare • • • • Cardiac intensivistsuniquelytrained inbothcardiology andcriticalcare Multidisciplinary, specializedteam • • • • providers• 24/7coverage byamultidisciplinary team of Comprehensive servicesforhigh-acuity, complex patients The care team undergoes arigorous in-housetraining program that includes and Cardiac Advanced LifeSupport, intra-aortic balloon pumpplacement, simulation training inhigh-acuity situations, suchasemergency resternotomy and transvenous pacemaker placement assistants, cardiac specializedintheuniquecare andvascularpatients of Advanced practice pr assist devices(LVAD, RVAD, BiVAD, Impella) (VA) ECMO, intra-aortic balloon, as welltemporary percutaneous ventricular four sides of the bed thebed four sidesof and data outletsallowultimate flexibility andunrestricted accessfrom all internal medicine, anesthesiology, surgery, andemergency medicine patients withmulti-systemorgan dysfunction increases itsabilitytoprovide sophisticated andholisticcare forcomplex of thecare team,of includingphysicians, APPs, nurses, andotherclinicians Palliative care isfullyintegrated Interdisciplinary rounds are madewithfamilymembersandall Nurses withspecializedtraining inCVICUcar Physicians specializedincriticalcare medicinewithprimaryboar CVRecent expansion criticalcare of at MedStar UnionMemorialHospital Capability toprovide temporary circulatory support, includingveno-arterial Rooms withceiling-mountedboomscarryingmedicalgases, andelectric 80 bedsforcomplex sur         oviders (APP), includingnursepractitioners andphysician gical andmedicalpatients e d training in

medical patients surgical and for complex 80

Beds MEDSTAR HEART & VASCULAR INSTITUTE to support the expansion of theirfocusareasto support theexpansion of today. were ontheleadingAPPutilization edgeof andwecontinue sites, andambulatory care locations. Thirty-five years ago, we care throughout thesystem—inacutesettings, outpatient growing cardiovascular group specialists. of They provide Our advancedpractice providers (APPs) are anintegral and Advanced practice providers CV APPs 113 initiatives across the inpatient service. also involved in qualityimprovement physicians upondischarge. They are may serveasaliaisontocommunity admitting cardiologistspatients of and coverage. This team managescare for cardiovascular care and provide 24/7 Our hospitalistsare dedicated to Cardiac hospitalists APPs Cardiovascular | Advanced Practice Providers/Nursing/Hospitalists/Anesthesiologists

• Pulmonary hypertension therapies • Electrophysiology procedures • Medication titration • ECMOtechnology and surgical therapies including: Our nursesplayacriticalrole throughout thepatient journey, andare involvedinnichemedical The ourpatients requires high-acuityandcase complexity of sophisticated nursingexpertise. Nursing intra-, andpost-operative management. anesthesiology team provides criticalpre-, complex, sophisticated procedures. This have multiplecomorbidities andundergo cardiovascular patients. These patients often manage theuniquechallenges of Fellowship-trained anesthesiologists anesthesiologists Cardiac Cardiovascular nurses 700

+ • COVID-19 treatment protocol • Devicemonitoring, includingtheImpella5.5 • Short-stay TAVR andSTEMI care • • • highlights include: are amajorfocusforournursingteams. Somerecent Continuing education andadvancedcertifications from the American NursingCredentialing Center to receive thePathway toExcellence designation The firstacutecare hospitalin Washington, D.C. the Critical-Care Nurses CVICU nursesbythe American Association of Certification our ahighpercentage of of Certification ournursing residency program of by Commission onCollegiate NursingEducation highlights Education andcertification

31 CAPABILITIES PERFORMANCE OUTCOMES 32 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH Baltimore region Cardiovascular Research Scientific Director John C. Wang, MD Cardiovascular Research and Advanced Education Director Ron Waksman, MD | Research nurses, technicians, sonographers, andsupport comprisethenetwork. staff World-renowned investigators, basicandtranslational scientists, interventional cardiologists, research evaluation, cardiovascular core laboratories, andacademic ClinicalResearch Organization (CRO). infrastructure forclinicalstudies. Research isfurther enhancedbyourstate-of-the-art pre-clinical The MedStar Cardiovascular Research Network, MedStar Health part Research of Institute, isthe theworld’sin someof mostprogressive cardiovascular investigations. the Centers forMedicare &MedicaidServices, andotherleading institutionsadvancesourparticipation Ongoing collaboration Health, withtheNational Institutesof theU.S. Food andDrug Administration, ourhospitallocations. place at manyof provide optimaloutcomesforallpatients. Our research extends throughout MedStar Health, taking We are committed todevelopingnewtechnologiesandstrategies toadvanceclinicalknowledgeand Research 16 leads Scientific

Investigators 50

MEDSTAR HEART & VASCULAR INSTITUTE staff and support Associates 85 | Research 115 reviewed journals annually inpeer- Publications • • • • to improve practice andtreatment outcomes. the world’s leading cliniciansandthelatest research inorder Washington HospitalCenter, isdesignedtoprovide accessto CRT, MedStar supported byandlocated onthecampusof CRT: Cardiovascular Research Technologies procedures inthefield. Visit on newcardiovascular technologyandinterventional as aforumforphysiciansandhealth-care professionals Held each year in Washington, D.C., theconference serves from eightlocations around the worldwere presented. annual, more than1,300presentations and20livecases cardiovascular specialists. At the2020meeting, the24th cardiology conferences, attended bymore than3,000 developments inthefield. Visit CRTonline.org. content tokeep physiciansuptodate onthelatest or visitCRTvirtual.org. For more information ortoregister, seepage and cardiovascular imagingandphysiology. women inheart disease, valveandstructural disease, topics across thecardiovascular spectrum, including revascularization therapies incardiovascular medicine. original laboratory andclinicalinvestigations related to international, peer-reviewed journalthat publishes theCRTis theofficial journalof meetingandisan Cardiovascular Revascularization Medicine(CRM) CRTvirtual CRTmeeting CRTonline 

provides exclusive interventionalcardiology

is aweeklyvirtual conference ontimely is one of theworld’s isoneof leading interventional CRTmeeting.org.

35

175 studies ongoing Current

33 CAPABILITIES PERFORMANCE OUTCOMES 34 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH | Graduate Medical Education subspecialties: cardiovascular variety of to train ina opportunity have the Fellows opportunities Subspecialty learning environment forourcardiovascular fellows. complex patients intheregion. We are committed toarichandrigorous programs andfaculty, themostadvancedtechnologyand plussome of largest intheUnitedStates. Candidates have accesstoeliteclinical MedStar Health's graduate medicaleducation program the isoneof Graduate medicaleducation

Echocardiography Cardiac CT and MRI 1 1

General cardiology Electrophysiology Fellows 18-24 29-35 2

Interventional Interventional Heart failure cardiology 2 5 • • • • population through rotations at: Fellows gainexperience withadiverse Diverse experience *2019-2020 surveynotavailableduetoCOVID-19 their programs thehighestpossiblerating our2018/19cardiovascular fellowsgive of Washington DC VA MedicalCenter Children’s National Hospital MedStar Georgetown UniversityHospital MedStar Washington Hospital Center 94% MEDSTAR HEART & VASCULAR INSTITUTE issues related tocardiovascular health. with lawmakers onCapitol Hillabout CardiologyCollege of indiscussions fellows havejoinedthe American advocacy andpolicy. For example, proximate involvementinhealthcare allows fellowstheopportunity for Our location in Washington, D.C. nation’s capital Location inthe Institute. Clinic Heart, Vascular & Thoracic Health andCleveland Institutes of programs, includingtheNational studies, aswellthoseat partner through ournumerous ongoing research, clinicaltrials, andpublication opportunities forinvolvementin Fellows are provided unique Research andinnovation

| Continuing Medical Education for information onallregularly scheduledseries, including: Please visit Regularly scheduledseries To request aninvitation, please [email protected]. cardiology cases. engage inthought-provoking discussionregarding interventional Colleagues from hospitalsinD.C., Maryland, and Virginia (DMV) Monthly, evenings Virtual course DMV Cath LabCase Review Register at CRTvirtual.org. coronary, structural heart, andendovascularprocedures. and research data, aswellcasereview andchallengingissuesin Each sessionwillincludeadeepdiveintodevices, clinicaltechniques, Saturdays, 8a.m. tonoon Virtual course CRTvirtual • Cardiology • Cardiac surgery • Cardiac catheterization attendees from across theglobe. We inviteyoutojoinus. Our coursesandconferences attract weekly hundreds of Peer collaboration andcontinuingeducation are paramount. education Continuing medical MedStar.Cloud-CME.com • Cardio-oncology • Electrophysiology • Echocardiography or call 202-780-1655

35 CAPABILITIES PERFORMANCE OUTCOMES 36 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH involve cardiovascular patients. ECMO, IABP, LVAS, andpressure control ventilation. Nearlytransports 50percent of care intheair. Patients canbetransported onmultiplevasoactivemedications, Flights are staffed witha criticalcare nurseandparamedic, providing tertiary-level and man-made. most dramatic andtraumatic eventstoaffect thenational capital area, bothnatural Since itsinaugural flightin1983, MedSTAR Transport hasbeenonthescenefor with helicoptersandcritical-care ambulances. injured patients. The transfer centeroperates 24/7, coveringthemid-Atlanticregion Our MedSTAR Transport servicesetsnational standards criticallyillor forthecare of MedSTAR Transport MedStar Health. leadership gift wasthelargest singlecontributioninthehistoryof generosity andextraordinary philanthropic support. Their $10million recognize longtime Washingtonians NancyandHarold Zirkinfortheir The NancyandHarold ZirkinHeart & Vascular Hospital wasnamedto that drivesmore effective, streamlined care. virtually theentire heart andvascularcare team inonecentral location MedStar HeartServing asacornerstoneof & Vascular Institute, itunites MedStar the-artWashington facilityonthecampusof HospitalCenter. The NancyandHarold ZirkinHeart & Vascular Hospital isastate-of- The NancyandHarold Zirkin Heart & Vascular Hospital | Zirkin Heart & Vascular Hospital /Cleveland Clinic Alliance /MedSTAR Transport

Cleveland Clinicalliance innovative cardiovascular therapies. expertise andlarge anddiversepatient populations inthepursuitof resulting inacollaborative approach toresearch. We share individual communication betweenthescientistsandcliniciansat bothInstitutes, protocols, andvalidate andreport outcomes. The alliancefacilitates fluid experts toimplementqualityimprovement initiatives, evaluate treatment At theoperational level, ourcliniciansworkcloselywithqualityandsafety United States. thelargestcollaboration cardiovascular betweentwoof programs inthe Clinic’s MillerFamily Heart, Vascular & Thoracic Instituteoffers coordinated Now initsninthyear, ourclinicalandresearch alliancewithCleveland MEDSTAR HEART & VASCULAR INSTITUTE Quality andSafety Medical Director Mouin Abdallah,MD | Quality andSafety • INTERMACS • Vascular QualityInitiatives (VQI) • LAAO • AFib • AHA Get With theGuidelines • ACC/NCDR (Cath/PCI; ChestPain/MI; ICD) • STS • STS/ACC TVT Registry We publiclyshare ourperformancedata withthefollowingregistries: benefits patients successfulqualityimprovement and expedites dissemination interventions. of Clinic, whichhelpsfacilitate rapid-cycle qualityimprovements. The abilitytolearn from oneanother Enhancing internalprocesses isourlong-standing, collegial, andtransparent relationship withCleveland departments occursonarotating basis. performed monthly. ourcardiovascular In-depthanalysisintoeach subspecialtiesandsurgical of A comprehensive ourqualitymetricsagainstinternal goalsandnational review benchmarks is of care.and outcomesmetricsacross thespectrumof by approximately 20physicians, nurses, andsupport staff. This team monitors more than150processes MedStar Heart & Vascular Institutehasadedicated qualityandsafetyimprovement department operated Quality andsafety ™

37 CAPABILITIES PERFORMANCE OUTCOMES 38 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH Washington Region Chief,Practices Ambulatory Robert A. Lager, MD Baltimore Region Chief,Practices Ambulatory George D. Bittar, MD Cardiology Ricardo O. Quarrie, MD Ezequiel J. Molina, MD Hiroto Kitahara, MD Jeffrey E. Cohen, MD Brian T. Bethea, MD Ammar S. Bafi, MD MedStar Washington HospitalCenter Interim Chair, Cardiac Surgery Christian C. Shults, MD MedStar UnionMemorialHospital Chief, Cardiac Surgery Michael Fiocco, MD Cardiac Surgery Alexander I. Papolos, MD Benjamin B. Kenigsberg, MD MedStar UnionMemorialHospital Medical Director, Cardiovascular ICU Nimesh S. Shah, MD MedStar Washington HospitalCenter Medical Director, Cardiovascular ICU Christopher F. Barnett, MD Cardiac IntensiveCare Weining David Xu, MD Farooq H. Sheikh, MD George Ruiz, MD Maria E. Rodrigo, MD Sriram Rao, MD Ezequiel J. Molina, MD Hiroto Kitahara, MD Phillip H. Lam, MD Mrinalini Krishnan, MD Ajay Kadakkal, MD Sandeep M. Jani, MD Mark R. Hofmeyer, MD Jennifer R. Brown, MD Tolulope(Tolu) A. Agunbiade,MD MedStar Heart & Vascular Institute Director, Advanced Heart Failure Samer S. Najjar, MD Advanced Heart Failure Stuart F. Seides, MD, Physician Directory | Physician Directory

Physician Executive Director

John J. Kennedy, MD Christy L. Kaiser, MD Satish N. Jumani, MD Rodney A.Johnson, MD Estelle D. Jean, MD Sumbal A.Janjua, MD Stephanie S. Jacobs, MD Lawrence D. Jacobs, MD Stuart D. Gould, MD Raktim K. Ghosh, MD Mehdi Gheshlaghi, MD Robert A. Gallino, MD Ijeoma C. Ezeife, MD Louis K. Essandoh, MD Andrew W. Ertel, MD Daniel J. Dooley, MD Terrance A. Collins, MD Miriam L. Cohen, MD Hitesh Chawla, MD Harjit K. Chahal, MD Jeffrey J. Brown, MD Nanette H. Bishopric, MD Patrick T. Bering, MD Barbara L. Bean, MD Valeriani R. Bead, MD Orest B. Bartoszyk, MD Ana Barac, MD, PhD Federico M. Asch, MD Rahul Anand,MD Abdelrahman A. Aly,MD Jonathan A. Altschuler,MD Ebony R. Alston, MD Firehiwot Achamyeleh,MD Mouin S. Abdallah, MD Hospital MedStar Georgetown University MedStar Washington HospitalCenter Chairman, Cardiology Department of J.Allen Taylor,MD Hospital Center MedStar SouthernMaryland CardiologyChairman of William O. Suddath, MD MedStar UnionMemorialHospital MedStar HarborHospital MedStar GoodSamaritanHospital Cardiology of Chief George Ruiz, MD Medical Center MedStar Franklin Square Cardiology of Chief Sriram Padmanabhan, MD

Visit us at MedstarHeartInstitute.org/Doctor-Search Micheas Zemedkun, MD Raymond K. Young, II, MD Roquell E. Wyche, MD Bethel Woldu,MD Neil Weissman,MD Gaby Weissman,MD Richard I. Weinstein, MD William G. Weigold, III, MD Jose D. Vargas, MD Carolina I. Valdiviezo-Schlomp, MD Jeffrey B. Trabb, MD Kelley W. Sullivan, MD Anjili Srivastava, MD Monvadi B. Srichai-Parsia, MD Reed M. Shnider, MD Meena V. Shah, MD Ankit B. Shah, MD Anil K. Shah, MD Amish Shah, MD Stuart F. Seides, MD Alexander Ryzhikov, MD Adriana M. Rosario, MD Reginald L. Robinson, MD Oluseyi O. Princewell, MD John C. Patterson, MD Jonathan E. Patrick, MD Ronak K. Patel, MD Bhavin M. Patel, MD Anil Pandit, MD Nicholas Paivanas, MD Etonde M. Musonge-Tarkang, MD Mansoor Mozayan, MD Richard L. Morrissey, MD Edward I. Morris, MD William C. Maxted, Jr., MD John F. Marra, MD Rachel Marcus, MD Rahul Malik, MD Conor F. Lundergan, MD Michael B. Lee, MD Kenneth M. Lee, MD Benjamin I. Lee, MD Bryan LeBude, MD Preetham N. Kumar, MD Kerunne S. Ketlogetswe, MD Dawn W. Kershner, MD

Cyrus A. Hadadi, MD Michael S. Goldstein, MD Margaret B. Fischer, MD Sarfraz A. Durrani, MD Walter L. Atiga, MD Rafique Ahmed, MD Baltimore Region Cardiac Electrophysiology Medical Director Ezequiel J. Molina, MD VentricularDevices Assist Heart Transplantand Seth J. Worley,MD Allison C. Warren, MD Athanasios Thomaides,MD David A. Strouse, MD Sunjeet S. Sidhu, MD Manish H. Shah, MD Edward V. Platia, MD Susan O’Donoghue, MD Jay A. Mazel, MD Sung W. Lee, MD Malick Islam, MD Hospital Center MedStar SouthernMaryland Cardiac Catheterization Lab Medical Director William O. Suddath, MD MedStar Washington HospitalCenter Cardiac Catheterization Lab Medical Director Lowell F. Satler, MD Interventional Cardiology Hiroto Kitahara, MD Heart Transplantation Medical Director Maria E. Rodrigo, MD VAD andHeart Transplantation Surgical Director Glenn R. Meininger, MD MedStar Heart & Vascular Institute Director, Cardiac Electrophysiology Zayd A. Eldadah, MD, PhD Cardiac Electrophysiology

Stephen F. Stanziale, MD Kyle B. Reynolds, MD Mark O. Peeler, MD Krystal C. Maloni, MD Lucy B. Kupersmith, MD Suzanne S. Kool, MD Misaki M. Kiguchi, MD Geetha Jeyabalan,MD Ayesha Hatch, MD John Harvey, MD Faris Z. Hakki, MD Jesse P. Garcia, MD Arthur Flatau, III, MD Javairiah Fatima, MD Joshua A. Dearing, MD Jason R. Crowner, MD Jason A. Chin, MD Kevin A. Brown, MD W.Maggie Arnold,MD Cameron M. Akbari, MD Steven D. Abramowitz, MD Baltimore Region Director, VascularSurgery Raghuveer Vallabhaneni,MD DepartmentVascular of Surgery Chairman MedStar Health Vascular Program Director Edward Y.Woo, MD Vascular Surgery Nauman Siddiqi, MD Toby Rogers, MD Venkatesh K. Raman, MD David B. Peichert, MD Scott M. Katzen, MD Antony G. Kaliyadan, MD Hayder Hashim, MD Eric S. Ginsberg, MD Nelson L. Bernardo, MD Itshac ItsikBen-Dor, MD Malik A. Al-Omari,MD Srinivas Addala,MD MedStar UnionMemorialHospital Cardiac Catheterization Lab Medical Director John C. Wang, MD MedStar Washington HospitalCenter Associate Director, Cardiology, Cardiovascular Research Network; and Advanced Education, MedStar Director, Cardiovascular Research Ron Waksman,MD

MEDSTAR HEART & VASCULAR INSTITUTE 410-554-2332 call theHeartLine: 1-888-529-0200 or To schedule procedures: Medical Center MedStar Franklin Square 301-877-7353 Vascular surgery 301-877-5677 Interventional cardiology 301-877-5677 Electrophysiology Maryland HospitalCenter MedStar Southern 410-554-2332 call theHeartLine: 1-888-529-0200 or To scheduleprocedures: Memorial Hospital MedStar Union 202-877-0275 Vascular surgery 202-877-5975 Interventional cardiology 202-877-7685 Electrophysiology 202-877-7464 Cardiac surgery Hospital Center MedStar Washington Contacts at aglance

| 81 Important Telephone Numbers /Locations Map Hagerstown 70 Walkersville Manassas 66 Frederick Leesburg 7 Rehabilitation Hospital MedStar National Germantown Gaithersburg Clarksburg Lansdowne Fairfax 270 Bethesda North Potomac Mt. Airy Annandale 95 McLean Damascus Union Bridge Rockville Arlington Wheaton Olney

Fort Washington Mt. Vernon 395 70 Alexandria Groveton University Hospital MedStar Georgetown White Oak Hospital Center MedStar Washington Colesville Medical Center MedStar Montgomery Cloverly Hyattsville St. Charles 301 495 Westminster La Plata WASHINGTON, D.C. White Plains BALTIMORE Eldersburg Waldorf Clinton 495 Greenbelt Columbia Suitland 1 Randallstown Hospital MedStar St. Mary’s Brandywine Laurel Hampstead Hospital Center MedStar SouthernMaryland Charlotte Hall 95 100 Hospital MedStar Harbor

32 Reisterstown Palmer Park 795 Mitchellville Bowie Hughesville Elkridge Owings Mills Arbutus 5 695 Meade Fort Odenton Crofton Marlboro Upper 83 Leonardtown 83 4 Cockeysville Towson 97 2 Huntington Park Brooklyn Beach Chesapeake Burnie Glen Samaritan Hospital MedStar Good 895 695 Frederick Prince Memorial Hospital MedStar Union Hollywood Deale California Severna Park Overlea 695 Annapolis Side Shady Dundalk Perry Hall Jarrettsville Lexington Park Arnold Essex Edgemere 50 Joppatowne 1 Square MedicalCenter MedStar Franklin White Marsh Nottingham Bel Air Kent Island Chester Aberdeen 95 40 50 Cambridge Salisbury 39 CAPABILITIES PERFORMANCE OUTCOMES 40 CAPABILITIES PERFORMANCE OUTCOMES MEDSTAR HEALTH MedStar Washington HospitalCenter awarded MedStarHeartInstitute.org Washington, DC20010 110 IrvingSt., NW MedStar Heart & Vascular Institute MedStar Washington HospitalCenter MedStar Union MemorialHospital MedStar St. Mary’s Hospital MedStar Southern MarylandHospitalCenter MedStar National Rehabilitation Hospital MedStar Montgomery MedicalCenter MedStar Harbor Hospital MedStar Good SamaritanHospital MedStar Georgetown UniversityHospital MedStar Franklin Square MedicalCenter | Vascular Surgery