2024 Jeffrey M. Carlton Heart & Vascular Institute Impact Report

Jeffrey M. Carlton Heart & Vascular Institute 2024 Area Update

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Jeffrey M. Carlton Heart & Vascular Institute | Area Update 2024

World-Class Cardiovascular Care.

Because of You. This year marks the 10th anniversary of Jeffrey M. Carlton’s transformative gift to name Hoag’s heart and vascular institute. With its already exceptional patient care and resources enhanced by philanthropic support, the newly named Jeffrey M. Carlton Heart & Vascular Institute propelled even further. Since then, this investment and those of many other visionary people like you have made this institute one of the most renowned on the West Coast.

Our acclaimed physicians and specialists are delivering world-class patient care right here in Orange County, whether it’s in the operating room, at the bedside, or beyond Hoag’s walls during recovery. With your support, we can continue recruiting recognized expert physicians and staff and provide them the opportunities to grow.

While they care for the patients who need us today, our team always works toward the innovations of tomorrow. Research conducted by Hoag experts creates new technology, treatments, therapies, and more in the name of pushing cardiovascular care forward.

In the following pages, you’ll read highlights about the Jeffrey M. Carlton Heart & Vascular Institute team and what we’ve accomplished. Our team can work toward elevating because we know that you share our mission. For that, we are grateful.

Angela Devlin, MBA, RN, BSN Executive Director, Jeffrey M. Carlton Heart & Vascular Institute

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A Decade of Achievements Hoag’s cardiovascular care has made transformative achievements in the name of patient care and clinical advancements throughout its entire history. Below are some highlights just from the past decade:

Revolutionary HeartFlow system is implemented and is the first noninvasive diagnostic tool providing answers about coronary artery disease

Two newly renovated cardiac catheterization labs/ interventional radiology suites open at Hoag Hospital Irvine

Hoag becomes the first hospital in Orange County with the Siemens SOMATOM Force CT scanner, the most innovative imaging technology at the time used to diagnose and plan treatment for aortic disease

Jeffrey M. Carlton Heart & Vascular Institute is named after historic $53 million gift to Hoag

Hoag becomes first in Orange County to offer extracorporeal membrane oxygenation (ECMO) therapy for adults

Nancy & Bill Thompson Center for Cardiovascular Care is completed

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2019

The Elaine & Robert Matranga Aortic Center is named and expands with addition of the Marfan Syndrome and Related Conditions Program Hoag receives Get With The Guidelines® Gold Plus Awards from the American Heart Association for heart failure care

Hoag is designated an Extracorporeal Life Support Organization (ELSO) Center of Excellence

Hoag physician leader Dipti Itchhaporia, MD, MACC, FAHA, FESC, FRCP, the Eric & Sheila Samson Endowed Chair in Cardiovascular Health, was appointed president of the American College of Cardiology (ACC) Hoag is among first in the world to successfully implant dual-chamber leadless pacemaker in a patient

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Surgeon Spotlights Antonio Covarrubias, MD, RPVI Vascular & Endovascular Surgeon Dr. Covarrubias is the newest addition to the Jeffrey M. Carlton Heart & Vascular Institute team, joining Hoag in October 2023. He is a double board-certified vascular surgeon who treats the full spectrum of vascular diseases, including peripheral arterial disease, chronic venous insufficiency/ varicose veins, limb wounds, aortic aneurysms, carotid disease, and he provides access to dialysis.

Dr. Covarrubias graduated from medical school in Argentina before moving to the United States to complete his training in general surgery at Loma Linda University and a vascular surgery fellowship at UC San Diego Health.

Asad Shah, MD, FACC, FACS Cardiothoracic Surgeon Co-Director, Hoag Cardiac Surgery Dr. Shah leads the robotic cardiac surgery program at Hoag and performs the full spectrum of cardiac surgical procedures. His clinical interests include thoracic aortic disease, minimally invasive valve surgery, coronary artery bypass grafting, robotic cardiac surgery, and transcatheter therapies, including transcatheter aortic valve replacement (TAVR) and thoracic endovascular aortic repair (TEVAR). Dr. Shah has conducted extensive research in cardiovascular surgery, including studying the genetics of thoracic aortic aneurysms and bicuspid aortic valve syndrome.

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Jeffrey M. Carlton Heart & Vascular Institute | Area Update 2024

Exceptional Surgery Outcomes Hoag’s outcomes in robotic cardiovascular surgery outshine those of other programs across the country. The four busiest programs are at the Mayo and Cleveland Clinics and Yale and Emory Universities. The median age of Hoag patients, 67, is also higher than those in the busiest programs in the country, which means that while our patients are at higher risk, our outcomes are still better.

Robotic Cardiac Surgery Mortality Rates

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Procedure Spotlight | Transcarotid Artery Revascularization (TCAR) Hoag is the highest volume provider in Orange County of transcarotid artery revascularization (TCAR), a minimally invasive procedure that can clear blockages and open a narrowed carotid artery. This is possible because of our state-of-the-art facilities—like the Bob & Marjie Bennett Hybrid Cardiovascular Surgical Suite—which allow us to perform new, leading-edge procedures that enhance patient care and experiences. When the surgical suite was introduced, it was the first operating room of its kind in Orange County, enabling advanced diagnostic imaging and surgical procedures to be performed simultaneously in the same room. TCAR is one of those procedures, which is a highly effective option for the treatment of carotid artery stenosis, namely for people who are not candidates for open-heart surgery.

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Investing in state-of-the-art medical equipment is crucial for ensuring our hospital provides the highest quality care. By having cutting-edge technology, we empower our health care professionals to diagnose, treat, and care for patients with precision and efficiency, ultimately enhancing patient outcomes and safety. It is through the Hoag Hospital Foundation’s generous donors that we can make this a reality at our institution, and it makes me proud to know that we will continue to be at the forefront of innovative care.”

Emaad Farooqui, MD, MHA, RPVI Vascular Surgery

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Jeffrey M. Carlton Heart & Vascular Institute | Area Update 2024

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Elaine & Robert Matranga Aortic Center The Elaine & Robert Matranga Aortic Center offers a comprehensive approach to aortic care for every stage of a person’s journey, including prevention, diagnosis, treatment, and long-term surveillance. The center monitors over 1,500 patients. In recent years, the center expanded its ability to manage and treat complex aortic pathology with the launch of the Marfan Syndrome and Related Conditions Program, a lifeline for people with rare connective tissue conditions.

The Matranga Aortic Center was named a high-volume center in 2023 by the American College of Cardiology and the American Heart Association Guidelines for Diagnosis and Management of Aortic Disease. This makes Hoag a preferred provider and model of aortic care best practices with dedicated cardiac, surgical, and anesthesia teams that provide leading-edge care.

Prevention: For patients who are found to have aortic disease, Hoag offers genetic testing to determine whether anyone else in the patient’s family might also be at risk. Genetic counselors facilitate notifying family members of these conditions and guide follow-up care.

Treatment: Some patients enter Hoag’s long-term active surveillance to stay ahead of aortic disease, receiving guidance from a team that personalizes care to them. This approach has led Hoag to become the referral center for aortic disease in Southern California.

Innovation: Hoag is also committed to aortic research, giving patients access to global studies that are opening the door to new insights and treatments of aortic disease. Hoag is now harnessing the power of artificial intelligence (AI) in imaging to detect aortic dissections more quickly in the emergency room, enabling staff to deliver lifesaving care sooner. This is especially impactful given the risk of mortality for dissections increases by 1 to 2% every hour.

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In 2023, the Matranga Aortic Center performed:

97

Aortic surgeries

21 emergency cases 0% Operative mortality rate, far below the national average of 19%

Hoag’s Aortic Disease Awareness Day Each year, Hoag’s Aortic Disease Awareness Day brings together patients who have experienced aortic diseases, their families, physicians, nurses, and more to share stories and information about these diseases and other related connective tissue conditions.

Scan here to watch Heather Lendrum’s aortic dissection survival story.

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New Staff Spotlight: Nurse Practitioner Anna Rourke, MSN, AGACNP-BC, ENP-C, FNP-C The Jeffrey M. Carlton Heart & Vascular Institute team in May 2023 welcomed nurse practitioner Anna Rourke. Hoag’s specialized nurse practitioner positions, including Anna’s, are funded by philanthropy and elevate care for Hoag patients. While Anna is focused on cardiology at Hoag, she has vast experience and is triple board certified in adult-gerontology acute care, emergency care, and primary care.

Nurse practitioners play a vital role within the health care team by performing a wide range of functions, including the diagnosis and treatment of disease and injury, health promotion and disease prevention, health and wellness education, quality improvement, and program management. Prior to joining Hoag, Anna practiced in cardiology and emergency medicine as well as held a faculty position at California State University, Long Beach teaching nurse practitioner students. In her current role, she provides patient education to those with cardiovascular disease, supervises cardiac stress tests, chairs Hoag’s Acute Myocardial Infarction Committee, is the Cardiovascular Receiving Center coordinator, and participates in other Hoag committees and initiatives focused on the continual improvement of patient care. Anna recently earned her Basic Certificate in Quality and Safety from the Institute for Healthcare Improvement.

Since joining Hoag, Anna has become a certified health coach so that she can work more effectively with patients to implement a heart-healthy lifestyle. “I spend a lot of time talking with patients about preventive cardiology and strategizing ways to incorporate heart-healthy choices into their daily routine. It’s one thing to know better, but it’s another thing to do better,” Anna said. “Each conversation is personalized, and each plan is tailored to the individual’s needs and goals.”

Anna’s passion for cardiology care stems from her family. Her beloved grandparents both had heart conditions, and she spent time during her childhood in medical facilities watching those providing care. “I thought, ‘Wow, these clinicians are giving me more time with my grandparents,’ and then it became my goal,” Anna said. She recognizes that there is something special about Hoag and her colleagues.

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Jeffrey M. Carlton Heart & Vascular Institute | Area Update 2024

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I’ve worked all over the place at some great hospitals, but there’s nowhere like Hoag.

People are truly mission-driven and really care.”

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Patient Spotlight: Kenneth Kamp When a routine physical exam for Los Angeles firefighter Kenneth Kamp uncovered a heart murmur, his cardiologist recommended Kamp seek out Hoag’s experts. That led him to Asad Shah, MD, co-director of cardiovascular surgery at Hoag, who performed his robotic mitral valve repair surgery. Kamp’s first interaction was with Barbara Eklund-Horn, MSN, RN, a cardiac nurse navigator. “Barbara is just amazing. And then there is Dr. Shah, who is a mild-mannered, soft-spoken, confident person,” he said. “I walked out after scheduling my heart surgery feeling good.”

The eight-hour surgery involved five incisions and required that his right lung be deflated. But he was only in the hospital for five nights following the surgery, and all things considered, he rather enjoyed his stay. “Everyone is so nice, and you have this beautiful view of Newport Harbor,” he said. Kamp was given rehabilitation guidance while in the hospital and began his own regimen right away. He returned to work after just eight weeks. Kamp’s follow-up echocardiograms look good, and he lauds Hoag’s team and his experience as a whole. “They treated me like I was their son or brother rather than just another body to them. They’re amazing. It’s just a different level.”

Fostering Communities of Healing Through collaboration with local and national organizations and by hosting events, Hoag creates opportunities for people who share cardiovascular conditions or clinical experiences to build camaraderie. Our physicians stride alongside their patients during awareness walks, our nurses encourage families at conferences, and patients build connections with each other during support groups and workshops.

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Jeffrey M. Carlton Heart & Vascular Institute | Area Update 2024

In 2023, Hoag sponsored, organized, and participated in several functions and groups: • Hoag served as the presenting sponsor for the 2023 Southern California Walk for Victory in Costa Mesa to increase awareness and raise funds to help save lives and improve the quality of life for people with Marfan syndrome, Loeys-Dietz, Vascular Ehlers-Danlos syndrome, and related conditions.

• Hoag’s Aortic Dissection Survivor Support Group is a recurring opportunity for patients, their families, and support network to gather to share personal experiences, coping strategies, concerns, and triumphs.

• Hoag’s Heart Matters Support Group meets monthly to discuss a variety of emotional issues—like depression, anxiety, or anger—relating to heart disease for those healing and recovering from a cardiac event.

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Advancing Cardiovascular Care & Technology Hoag Among the First to Implant Dual-Chamber Leadless Pacemaker In November 2023, Hoag announced the successful implant of the world’s first dual-chamber leadless pacemaker in a patient, marking a new era in cardiac care.

The AVEIR™ DR, the pacemaker system by Abbott, was featured in TIME on its list of The Best Inventions of 2023. Hoag was one of a few initial sites in the nation to participate in the launch of this technology, which speaks to the hospital’s national reputation.

“This advanced technology is a game changer for cardiac patients. It is an exciting opportunity to provide our patients with access to groundbreaking technology as soon as it becomes widely available,” said Hoag clinical cardiac electrophysiologist Rajesh Banker, MD, who performed the surgery and served as the principal investigator in a trial of the pacemaker at Hoag. “I am proud to work at a hospital that supports specialists like me with the resources to conduct leading-edge research and offers cutting-edge technology that advances medicine and improves patient care.”

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Jeffrey M. Carlton Heart & AT Vascular CATALYZING INNOVATION HOAGInstitute | Area Update 2024

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One of the advantages of undergoing the study at Hoag is that our surgeons are highly experienced in mitral valve surgery. ” Anthony Caffarelli, MD, FACC, Newkirk Family Endowed Chair in Aortic Care

Mitral Valve Replacement and the MOMENTIS Study Hoag is part of a long-term study designed to collect clinical outcomes for a new mitral valve replacement option. The MOMENTIS study follows patients who receive the MITRIS RESILIA valve. The Jeffrey M. Carlton Heart & Vascular Institute is one of the first sites that enrolled patients into the trial with plans to expand trial locations globally.

“One of the advantages of undergoing the study at Hoag is that our surgeons are highly experienced in mitral valve surgery,” said Anthony Caffarelli, MD, FACC, Newkirk Family Endowed Chair in Aortic Care and director of cardiothoracic surgery and the Elaine & Robert Matranga Aortic Center at Hoag. Dr. Caffarelli, principal investigator for the Hoag trial, added, “Patients can access these valves without being part of the study; those who participate in the study have the advantage of being followed for 10 years and having a portion of their follow-up care and testing paid for as part of the clinical trial.”

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Rampart Ic Shields Interventional cardiology is ranked as an occupation with one of the highest levels of radiation exposure. For decades, cardiac professionals have relied on heavy lead aprons weighing up to 30 pounds to protect themselves from radiation.

Thanks to philanthropy, Hoag has acquired our first Rampart ic radiation shields, which provide a fully adjustable and portable system that delivers full-body radiation protection. Acquiring these shields at Hoag allows technologists to work side by side with cardiologists, offering more skilled treatments and a team approach that benefits patients.

Rampart ic shields provide radiation protection without the need for heavy aprons.

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Jeffrey M. Carlton Heart & AT Vascular CATALYZING INNOVATION HOAGInstitute | Area Update 2024

TRIBE-HF II Remote Patient Monitoring This study, coordinated by Dipti Itchhaporia, MD, MACC, FAHA, FESC, FRCP, the Eric & Sheila Samson Endowed Chair in Cardiovascular Health, closed at the end of 2023 and monitored heart failure patients for six months, assessing readmission reduction and quality of life improvement through the use of a remote patient monitoring platform.

Hoag provided patients with a Bluetooth scale, smartwatch, and phone application to track daily biomarkers including weight, voice recording, heart rate and rhythm, and sleep length and quality. During this study, patients also did at-home finger pricks so that blood samples could be compared to the other biomarkers. Hoag was one of just nine sites in the United States conducting this trial and had the highest enrollment.

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Accolades Highest Distinction from the Society of Thoracic Surgeons Hoag earned the highest distinction possible, a three-star rating out of three stars, from the Society of Thoracic Surgeons (STS) for three categories of surgery—isolated aortic valve replacement (AVR), isolated mitral valve replacement and repair (MVRR), and isolated coronary artery bypass grafting (CABG).

Fewer than 10% of hospitals nationwide have received this designation.

Designated an ELSO Center of Excellence This year, Hoag was notified that our extracorporeal life support (ECLS) program achieved the Silver Level ELSO Award for Pathway to Excellence in Life Support, as well as a three-year designation as an Extracorporeal Life Support Organization (ELSO) Center of Excellence, from 2024 to 2027. This award recognizes ECLS programs worldwide that distinguish themselves by having processes, procedures, and systems in place that promote excellence and exceptional care in extracorporeal membrane oxygenation. This is a major accomplishment for Hoag’s Advanced Heart Failure Program and would not be possible without the support of philanthropy.

This high distinction makes Hoag the only Silver Level ELSO Award recipient in Orange County.

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Jeffrey M. Carlton Heart & Vascular Institute | Area Update 2024

Bob & Georgia Roth’s Commitment to Hoag’s Advanced Heart Failure Program Bob and Georgia Roth’s dedicated support enabled Hoag to receive the ELSO Center of Excellence designation, a major achievement that was years in the making. Over time, the Roths’ support empowered Hoag to recruit staff, provide ongoing training in the area of extracorporeal membrane oxygenation (ECMO), and acquire the latest equipment.

This past year, Hoag team members attended the Extracorporeal Life Support Organization (ELSO) conference in Seattle, thanks to the Roths’ support.

There they participated in training and educational sessions to advance their skills. ECMO is a critical part of Hoag’s Advanced Heart Failure Program, requiring specially trained physicians, nurses, and equipment to provide and administer bridge therapies for patients in advanced cardiac and pulmonary distress. Because of Bob and Georgia Roth’s support, our team can partake in opportunities that enrich their knowledge and help further elevate patient care.

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Thank You Your dedication to Hoag and to people with cardiovascular conditions is inspiring. We are grateful for the trust you’ve placed in us through your support of the Jeffrey M. Carlton Heart & Vascular Institute. Because of your generosity, our patients have peace of mind knowing they have the most comprehensive care available; our physicians can innovate to pioneer the latest treatments; and our staff can thrive by continually aiming higher and growing their skills.

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Jeffrey M. Carlton Heart & Vascular Institute | Area Update 2024

Our vision has always been to provide exceptional personalized care while also prioritizing research and innovation. Thanks to your support, we can do all those things, which helps us today and allows us to invest in the future.

The Jeffrey M. Carlton Heart & Vascular Institute is renowned, a lifeline for many, and a health care stronghold in Orange County that is also nationally acclaimed. That is possible because of generous people like you. We appreciate you and your commitment to Hoag.

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For more information about supporting cardiovascular care at Hoag, contact: Camille Schwan, senior director of development, at 949-764-7244 or Camille.Schwan@hoag.org HoagHospitalFoundation.org