Cardiothoracic Surgery Program

Home , Heart valve repair, Valve replacement

proprietary and confidential Cardiothoracic Surgery Program

• Coronary artery bypass grafting (CABG) • Off -pump coronary artery bypass (beating heart surgery) • Heart valve repair or replacement • Minimally invasive valve repair • Transcatheter Aortic Valve Replacement (TAVR) • Thoracic and abdominal aortic dissections • Endovascular aortic stent grafting

proprietary and confidential Cardiac Surgery Volumes

Cardiovascular Surgery Volume

CABG CABG + Valve Valve TAVR Other

n=366 R 4 Qtr 219 43 79 16 9 (Ending Q3)

n=374 2012 223 49 75 17 10

2011 221 49 80 15 n=365

0 50 100 150 200 250 300 350 400

proprietary and confidential Valve Repair and Replacement

• Open -chest or minimally invasive surgical techniques • 3- D transesophageal echocardiography (TEE) in OR • Mitral valve replacement and repair • Aortic valve replacement and repair

proprietary and confidential Valve Replacement

proprietary and confidential Valve Repair

proprietary and confidential Cardiac Valve Surgery

Valve Breakdown Qtr. 4 2012 to Qtr. 3 2013

12% AVR 2% AVR + MVR AVR + TVR CABG + AVR 35% CABG + AVR + MVR CABG + AVR + TVR 16% CABG + MVR CABG + MVR + TVR CABG + TVR 1% MVR 1% MVR + TVR 10% TAVR 2% TVR 17% 1% 1% 1%

proprietary and confidential Minimally Invasive Surgical Procedures

• Mitral valve repair and replacement • Atrial septal defects • Removal of cardiac tumors • Atrial fibrillation (Maze) • Stent grafts for aortic aneurysms and dissections

proprietary and confidential Aortic Treatment Program

• Provide rapid diagnosis and treatment of life-threatening thoracic aortic syndromes and other specialized aortic conditions • Type A (ascending) aortic dissection • Type B (descending) aortic dissection • Symptomatic or leaking thoracic aneurysms • Intramural hematoma • Penetrating ulcers • Traumatic aortic transsection or injury • Asymptomatic thoracic aortic aneurysms requiring monitoring for expansion or elective repair

proprietary and confidential Ventricular Assist Devices (VAD)

• Offers temporary support for one or both ventricles in circumstances where the heart has failed but has the potential to recover • Cardiogenic shock following events such as acute MI, myocarditis or open heart surgery • Approved for all potentially recoverable indications of acute heart failure

proprietary and confidential CARDIAC SURGERY R 4 Qtr 2012 STS Benchmark OUTCOMES (Ending Q3)

CV Major Surgery Mortality 2.10% 2.40% 2.30%

CABG Mortality 1.40% 1.90% 1.40% CABG Deep Sternal Infection 0.00% 0.30% 0.00% CABG Re-op for Bleeding 0.50% 1.80% 1.00% CABG Post-op Permanent Stroke 0.50% 1.20% 0.50% CABG Readmits 6.20% 9.50% 5.70% CABG ALOS (in days) 9 9.2 9.1

proprietary and confidential Cardiac Surgery Team

• 5 board certified cardiothoracic surgeons • 4 physician assistants • Dedicated cardiac anesthesiologists, certified in transesophageal echocardiography (TEE) • Dedicated cardiac operating room staff 24 hours/day • Critical care and telemetry nursing staff • Cardiac nurse educators • Pharmacy, respiratory and physical therapy staff

proprietary and confidential Questions?

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