CS Smidt Heart Institute AR 2024

ANNUAL REPORT 2024

TRANSFORMATIONAL HEART CARE STARTS HERE

1 IN CALIFORNIA (highest U.S. News & World Report ranking in the region) AND #2 IN THE U.S. FOR CARDIOLOGY, HEART & VASCULAR SURGERY #

MESSAGE FROM OUR LEADERSHIP For decades, people from all over the world have trusted their hearts to the Smidt Heart Institute at Cedars-Sinai.

A global leader in heart transplant, women’s heart disease, targeted therapies and a suite of minimally invasive procedures, the Smidt Heart Institute has received worldwide acclaim for consistently achieving the best outcomes for people with heart disease.

Our specialized care team treats the full spectrum of cardiovascular disease, including vascular abnormalities, congenital heart disease, heart failure, coronary artery disease, valve dysfunction and rhythm disorders. Working seamlessly with clinicians, our investigators break new ground with lifesaving research efforts that effect change in California and around the globe.

Whether patients travel thousands of miles for care or live blocks away from Cedars-Sinai, the Smidt Heart Institute’s focus on technology and innovation provides transformational care to all patients.

SMIDT HEART INSTITUTE

Executive Director: Eduardo Marbán, MD, PhD Mark Siegel Family Foundation Distinguished Chair Professor of Cardiology and Biomedical Sciences

DEPARTMENT OF CARDIOLOGY

Chair: Christine M. Albert, MD, MPH Lee and Harold Kapelovitz Distinguished Chair in Cardiology Professor of Cardiology

DEPARTMENT OF CARDIAC SURGERY

Chair: Joanna Chikwe, MD Irina and George Schaeffer Distinguished Chair in Cardiac Surgery in honor of Alfredo Trento, MD Professor of Cardiac Surgery SMIDT HEART INSTITUTE VASCULAR PROGRAM

Associate Director of Vascular Therapeutics: Ali Azizzadeh, MD Professor of Surgery

HIGHLIGHTS CARDIAC SURGERY PAGE 2

>1,500

No– 1

THE HIGHEST QUALITY RATING

ROBOTIC MITRAL VALVE REPAIRS, WITH NEAR 100% SUCCESS RATE

MITRAL VALVE REPAIR CENTER IN THE WESTERN U.S.

FROM THE SOCIETY OF THORACIC SURGEONS

INTERVENTIONAL CARDIOLOGY PAGE 4 WORLD-RENOWNED EXPERTS IN ALL STRUCTURAL HEART PROCEDURES

1,885

TAVRS PERFORMED TO DATE

MITRACLIPS PERFORMED TO DATE

THE MOST ADVANCED CARE FOR COMPLEX HEART FAILURE, WITH SOME OF THE NATION’S BEST OUTCOMES

HEART TRANSPLANT AND MECHANICAL CIRCULATORY SUPPORT PAGE 8

LARGEST HEART TRANSPLANT PROGRAMS IN THE U.S.

YEARS OF ROSS PROCEDURES, WITH ZERO EARLY MORTALITY

ADVANCED HEART DISEASE: HEART FAILURE PAGE 6

>6,000

ONE OF THE

>20

>1,600 TRANSPLANTS TO DATE

132

DURABLE AND TEMPORARY MECHANICAL CIRCULATORY SUPPORT DEVICES PLACED IN FY23

LUNG TRANSPLANT PAGE 10 PERFORMED THE

FIRST ROBOTICALLY ASSISTED

DOUBLE-LUNG TRANSPLANT STATE-OF-THE-ART CARE, USING

ELECTROPHYSIOLOGY PAGE 12 PIONEER DIAGNOSTIC TOOLS AND SPECIALIZE IN THE IDENTIFICATION AND TREATMENT OF

HEART DISEASE IN WOMEN

NATIONAL LEADERS IN

CARDIAC ARREST

PREVENTION AND RESEARCH

LEADING THE INTEGRATION OF

ARTIFICIAL INTELLIGENCE

INTO ADVANCED CARDIAC CARE AND IMAGING

CONGENITAL HEART PAGE 14

AORTIC DISEASES PAGE 16

SEAMLESS, COMPREHENSIVE CONGENITAL CARDIAC CARE, FROM CONCEPTION TO ADVANCED AGE

EXPERTS IN COMPLEX TREATMENT, INCLUDING OPEN AND ENDOVASCULAR AORTIC REPAIR

FIRST-IN-HUMAN NOVEL PERCUTANEOUS PULMONARY VALVE REPLACEMENT

RECOGNIZED BY THE MARFAN FOUNDATION FOR EXPERTISE IN COMPREHENSIVE GENETIC AORTIC AND VASCULAR CARE

ZERO 30-DAY SURGICAL MORTALITY FOR 190 CONSECUTIVE CASES

MINIMALLY INVASIVE TECHNIQUES FOR 57% OF LUNG TRANSPLANTS IN FY23

VASCULAR DISORDERS PAGE 18 MAJOR DESTINATION FOR MINIMALLY INVASIVE AND COMPLEX OPEN AORTIC SURGERY ADVANCED, PERSONALIZED CARE USING APPROVED AND INVESTIGATIONAL DEVICES

2024 ANNUAL REPORT

1

CARDIAC SURGERY Embracing Robotic Solutions for the Most Complex Cases Surgeons at the Smidt Heart Institute at Cedars-Sinai work tirelessly to increase the variety of procedures available to patients as well as the array of patients eligible for less invasive techniques.

Betty on the mayoral campaign trail

2

SMIDT HEART INSTITUTE AT CEDARS-SINAI

PROGRAM DIFFERENTIATORS Mitral Valve

→ Among the most experienced in the world in

robotically assisted mitral valve repair, having performed almost all mitral repairs robotically since 2006

→ Mitral repair rates >99.5% and mortality of <0.3%, surpassing national benchmarks

→ Recipient of the Mitral Valve Repair Reference

Center Award from the American Heart Association for superior outcomes and guidelineconcordant mitral repair

→ Perform more mitral repairs than any other

program in California, with the highest quality rating from the Society of Thoracic Surgeons Aortic Valve

Trailblazing Trials The surgery and structural heart teams at Cedars-Sinai lead the first-in-human transcatheter mitral valve replacement study (MISCEND) and the NIH-sponsored PRIMARY trial of surgical vs. transcatheter mitral repair for degenerative mitral regurgitation.

—

1 500

> ,

With the pace I’m → Decades of experience in Ross procedures, with zero keeping, I feel like I’mearly mortality → Deep expertise in aortic aneurysms, valvealready the mayor— % sparing root replacement and repair > and I have the → Home to the largest structural heart program in the U.S., enabling a thorough, collaborative stamina to do that. exploration of every option for every patient— no matter how high-risk the case I don’t feel fatigued.

No– I’m so glad I’m on SERVICE SPOTLIGHTS the other side of thisexpertise in heart and lung transplant, → Unique surgery and thatstructural I heart, robotic cardiac surgery, aortic surgery and mitral repair didn’t have my→chest Virtual consultations and expert second opinions for patients around the world cavity opened up.”

ROBOTIC MITRAL VALVE REPAIRS

COMPLETED TO DATE

99

REPAIR SUCCESS RATE

1

MITRAL VALVE REPAIR CENTER IN THE WESTERN U.S.

– Betty Ward-Cooper RELEVANT RECENT PUBLICATIONS Robotic mitral valve repair patient The price of freedom from tricuspid regurgitation.

Monroe, Louisiana N Engl J Med; PMID: 34767707

Robotic repair for Barlow mitral regurgitation: Repairability, safety, and durability. J Thorac Cardiovasc Surg; PMID: 35803829

2024 ANNUAL REPORT

3

CARDIAC SURGERY Embracing Robotic Solutions for the Most Complex Cases Surgeons at the Smidt Heart Institute at Cedars-Sinai work tirelessly to increase the variety of procedures available to patients as well as the array of patients eligible for less invasive techniques.

the case

After consulting with a regional specialist, Betty Ward-Cooper (74) was disappointed to hear she should expect open-heart surgery for her symptomatic mitral valve regurgitation. She began researching the latest techniques in mitral valve repair and consulted the Smidt Heart Institute’s surgeons for their expertise in minimally invasive solutions.

the care

Relieved her case could be managed with smaller incisions using robotically assisted surgery, and without a sternotomy, Betty opted to travel across the country to proceed with her care. Her mitral valve repair went smoothly, and she returned home to Louisiana a week after surgery.

the conclusion

Betty now exercises without breathlessness and has renewed energy from improved sleep. She enjoys an active retirement as a member of the school board and president of the Ouachita Parish Public Library System. She is currently campaigning to be the mayor of Monroe.

Betty on the mayoral campaign trail

2

SMIDT HEART INSTITUTE AT CEDARS-SINAI

PROGRAM DIFFERENTIATORS Mitral Valve

Trailblazing Trials The surgery and structural heart teams at Cedars-Sinai lead the first-in-human transcatheter mitral valve replacement study (MISCEND) and the NIH-sponsored PRIMARY trial of surgical vs. transcatheter mitral repair for degenerative mitral regurgitation.

→ Among the most experienced in the world in

robotically assisted mitral valve repair, having performed almost all mitral repairs robotically since 2006

→ Mitral repair rates >99.5% and mortality of <0.3%, surpassing national benchmarks

→ Recipient of the Mitral Valve Repair Reference

Center Award from the American Heart Association for superior outcomes and guidelineconcordant mitral repair

→ Perform more mitral repairs than any other

program in California, with the highest quality rating from the Society of Thoracic Surgeons Aortic Valve

—

1 500

> ,

ROBOTIC MITRAL

→ Decades of experience in Ross procedures,

VALVE REPAIRS

with zero early mortality

→ Deep expertise in aortic aneurysms, valvesparing root replacement and repair

→ Home to the largest structural heart program

in the U.S., enabling a thorough, collaborative exploration of every option for every patient— no matter how high-risk the case SERVICE SPOTLIGHTS

COMPLETED TO DATE

99%

>

REPAIR SUCCESS RATE

No– 1

MITRAL VALVE REPAIR CENTER IN THE WESTERN U.S.

→ Unique expertise in heart and lung transplant,

structural heart, robotic cardiac surgery, aortic surgery and mitral repair

→ Virtual consultations and expert second opinions for patients around the world

RELEVANT RECENT PUBLICATIONS

The price of freedom from tricuspid regurgitation.

N Engl J Med; PMID: 34767707 Robotic repair for Barlow mitral regurgitation: Repairability, safety, and durability. J Thorac Cardiovasc Surg; PMID: 35803829

2024 ANNUAL REPORT

3

INTERVENTIONAL CARDIOLOGY Innovating and Excelling at Complex Interventional Care Collaboration across interventional cardiology and cardiac surgery creates optimized care plans for each patient—minimizing surgical trauma and recovery time.

Tom biking on the coast of Guam

4

SMIDT HEART INSTITUTE AT CEDARS-SINAI

PROGRAM DIFFERENTIATORS

→ World-renowned experts in all structural heart

procedures, including transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve repair and replacement

→ Most experience in the world in transcatheter tricuspid valve replacement

→ Pioneers in advanced procedural planning for transcatheter valve therapies

→ Leadership in numerous clinical trials evaluating transcatheter valve replacement for mitral, tricuspid and pulmonary valves, published in journals such as The New England Journal of Medicine, The Lancet and the Journal of the American Medical Association

→ Faculty editors and contributors to Complex Cases in Structural Heart Intervention, a

I was anxious that compilation of richly documented case studies to guide users through complicated situations my life would never in interventional cardiology be the same after my heart attack.SERVICE SPOTLIGHTS Robust and collaborative teams offering a range Now, I’m back →out of procedures via minimally invasive catheterization there doing the→ Routinely conduct angiography, angioplasty, atherectomy, ablations and valvuloplasty things I love to →do.

I More than 10,000 procedures per year on patients across the life continuum was really fortunate of the few centers worldwide excelling in to be treated at→ One both percutaneous and surgical care for all four Cedars-Sinai.” heart valves

>

6,000 TAVRS COMPLETED TO

DATE—MORE THAN ANY OTHER U.S. CENTER

1,885

MITRACLIPS/TRANSCATHETER MITRAL VALVE REPAIR PROCEDURES—ONE OF THE LARGEST VOLUMES IN THE WORLD

–T om Mazzei C oronary artery disease patient RELEVANT RECENT PUBLICATIONS Transcatheter mitral valve repair for degenerative mitral B arrigada, Guam regurgitation. JAMA; PMID: 3721955 Transcatheter aortic-valve replacement in low-risk patients at five years. N Engl J Med; PMID: 37874020 Outcomes of repeat transcatheter aortic valve replacement with balloon-expandable valves: A registry study. Lancet; PMID: 37660719 2024 ANNUAL REPORT

5

INTERVENTIONAL CARDIOLOGY Innovating and Excelling at Complex Interventional Care Collaboration across interventional cardiology and cardiac surgery creates optimized care plans for each patient—minimizing surgical trauma and recovery time.

the case

Tom Mazzei (59) was referred to Cedars-Sinai after a heart attack necessitated treatments unavailable in Guam. Tom and his wife made the journey to Los Angeles expecting openheart surgery.

the care

Advanced imaging revealed a blockage in Tom’s left anterior descending artery that could be treated via a robotic mammary artery bypass—a procedure available at only a few hospitals across the globe. His surgeon diverted the mammary artery to feed blood to his heart. After a brief inpatient recovery period, Tom underwent minimally invasive stent placement via catheterization to relieve the blockage in his right coronary artery. Cross-disciplinary collaboration allowed reduced surgical trauma and a swifter return to physical activity for Tom.

the conclusion

Back in Guam for follow-up care with his own cardiologist, Tom has renewed his passion for longdistance bike rides and world travel—hobbies he is free to enjoy again with family and friends.

Tom biking on the coast of Guam

4

SMIDT HEART INSTITUTE AT CEDARS-SINAI

PROGRAM DIFFERENTIATORS

→ World-renowned experts in all structural heart

procedures, including transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve repair and replacement

→ Most experience in the world in transcatheter tricuspid valve replacement

→ Pioneers in advanced procedural planning for transcatheter valve therapies

→ Leadership in numerous clinical trials evaluating transcatheter valve replacement for mitral, tricuspid and pulmonary valves, published in journals such as The New England Journal of Medicine, The Lancet and the Journal of the American Medical Association

→ Faculty editors and contributors to Complex

Cases in Structural Heart Intervention, a compilation of richly documented case studies to guide users through complicated situations in interventional cardiology

>

6,000 TAVRS COMPLETED TO

DATE—MORE THAN ANY OTHER U.S. CENTER

1,885

MITRACLIPS/TRANSCATHETER MITRAL VALVE REPAIR PROCEDURES—ONE OF THE LARGEST VOLUMES IN THE WORLD

SERVICE SPOTLIGHTS

→ Robust and collaborative teams offering a range

of procedures via minimally invasive catheterization

→ Routinely conduct angiography, angioplasty, atherectomy, ablations and valvuloplasty

→ More than 10,000 procedures per year on patients across the life continuum

→ One of the few centers worldwide excelling in

both percutaneous and surgical care for all four heart valves

RELEVANT RECENT PUBLICATIONS

Transcatheter mitral valve repair for degenerative mitral regurgitation. JAMA; PMID: 3721955 Transcatheter aortic-valve replacement in low-risk patients at five years. N Engl J Med; PMID: 37874020 Outcomes of repeat transcatheter aortic valve replacement with balloon-expandable valves: A registry study. Lancet; PMID: 37660719 2024 ANNUAL REPORT

5

ADVANCED HEART DISEASE HEART FAILURE Outstanding Leadership, Unique Expertise

PROGRAM DIFFERENTIATORS

→ Create unique, multidisciplinary care plans for

more than 8,000 heart failure patients per year

→ Diagnose amyloidosis and assess its

pathophysiology using the most advanced imaging and testing and the newest therapies

→ Spearhead clinical trials for procedures, devices and novel therapies

Our world-renowned clinicians manage a high volume of complex heart failure cases in all areas, including pulmonary hypertension, amyloidosis, sarcoidosis and cardio-oncology.

As part of a comprehensive, multidisciplinary management program, patients receive cuttingedge care with access to novel therapies, heart transplantation, mechanical circulatory support and investigative trials.

→ Provide virtual second opinions for patients

—

→ Medication optimization and hemodynamically

AI Uncovers High-Risk Patients When combined with AI, large-scale observational studies led by Smidt Heart Institute investigators may offer major advances in cardiac risk prediction. Deep-learning AI algorithms that examined patient echocardiograms and basic clinical data outperformed trained sonographers in identifying high-risk patients in the first-ever randomized, blinded clinical trial of its kind.

Nature; PMID: 37020027

6

SMIDT HEART INSTITUTE AT CEDARS-SINAI

around the world

SERVICE SPOTLIGHTS

→ State-of-the-art diagnostics, including

CardioMEMS implantable pulmonary artery pressure monitors, technetium pyrophosphate scans, specialized cardiac MRI protocols and implantable loop recorders

→ Collaborative care with experts in cardiac

rehabilitation, regenerative medicine, genetic disorders, heart transplant, mechanical circulatory support, physical therapy and more guided therapy to reduce repeat admissions

→ Individualized evaluation for advanced heart failure therapies, from left ventricular assist devices to total artificial hearts

RELEVANT RECENT PUBLICATIONS

The future for patients with transthyretin cardiac amyloidosis is looking brighter. Circulation; PMCID: PMC9718300 TRANSFORM-HF-Can we close the loop on diuretics in heart failure? JAMA; PMID: 36648482 2023 ACC expert consensus decision pathway on management of heart failure with preserved ejection fraction: A report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol; PMID: 37137593

The Susanne and Ervin Bard Pavilion at the Smidt Heart Institute at Cedars-Sinai in the heart of Los Angeles 2024 ANNUAL REPORT

7

HEART TRANSPLANT AND MECHANICAL CIRCULATORY SUPPORT Uniting High Volume and High Quality As one of the largest heart transplant programs in the U.S., the Smidt Heart Institute at Cedars-Sinai offers excellent outcomes, exceeding national survival averages despite treating some of the most complex cases.

Matt fishing for Gerrard trout on Lake Pend Oreille

8

SMIDT HEART INSTITUTE AT CEDARS-SINAI

PROGRAM DIFFERENTIATORS

→ More than 34% of patients go from listing to

transplant within 30 days, exceeding the national average

→ Novel therapeutic options in the pretransplant, perioperative and posttransplant periods to reduce organ rejection

→ Precision medicine efforts evaluating patients’

genes, environment and lifestyle for individualized treatment strategies that optimize outcomes

132

DURABLE AND TEMPORARY MECHANICAL CIRCULATORY SUPPORT DEVICES PLACED IN FY23

→ An ex vivo perfusion (heart-in-a-box) program

that increases the number of usable organs by keeping the heart beating during transport, extending the distance a heart can be transported

→ A donation after cardiac death program, which

uses an ex vivo platform and normothermic regional perfusion to expand the donor pool and the number of heart transplants by about 25%

They saved my → Faculty recognized for their impact in the field, life. They do that including the International Society for Heart every day, I know, and Lung Transplantation’s 2023 Lifetime Achievement Award recipient but I’ve only got one life. So, to beSERVICE SPOTLIGHTS → Tailored included on that listimmunosuppressant regimen to transplant recipients’ unique factors is pretty special.” → Multiple faculty-led clinical trials to expand > – Matt , Philbrook patient care options

149

ECMO CASES IN FY23

126

HEART TRANSPLANTS IN FY23

1 600

H eart transplant patient B onner’s Ferry, Idaho

HEART TRANSPLANTS TO DATE

Tocilizumab to Target Inflammation and Alloimmunity After Transplant for End-Stage Heart Disease Investigators at the Smidt Heart Institute continue to lead research endeavors to improve survival and outcomes for heart transplant patients and make transplant successful for the sickest patients.

They have initiated a Phase II, prospective, multicenter, randomized, placebocontrolled clinical trial investigating the effects of tocilizumab on inflammatory and alloimmune responses and defining the utility of several noninvasive biomarkers for risk assessment, diagnosis and prognostics.

→ Routine use of statins based on our pioneering research, leading to only 5% organ rejection

→ Therapeutic options for antibody reduction in

one of the nation’s largest desensitization centers

→ Expertise in transplants for complex patients

bridged from mechanical circulatory support

RELEVANT RECENT PUBLICATIONS

Evolving trends and widening racial disparities in children listed for heart transplantation in the United States. Circulation; PMID: 35861769 2024 ANNUAL REPORT

9

HEART TRANSPLANT AND MECHANICAL CIRCULATORY SUPPORT Uniting High Volume and High Quality As one of the largest heart transplant programs in the U.S., the Smidt Heart Institute at Cedars-Sinai offers excellent outcomes, exceeding national survival averages despite treating some of the most complex cases.

the case

Matt Philbrook (61) presented with restrictive cardiomyopathy and chest inflammation due to radiation treatment for Hodgkin lymphoma in the 1980s. A heart valve replacement done locally in 2019 began to fail, and Matt’s Idaho cardiologist told him he would require a heart transplant from a center with advanced capabilities.

the care

After the Cedars-Sinai surgeons and comprehensive cardiology team told Matt they could perform the transplant, he temporarily moved to California for care while he awaited a heart. His tenuous condition required intra-aortic balloon pump therapy in the intensive care unit. When a heart became available, his transplant surgery went smoothly despite the radiation-induced calcification.

After short-term setbacks, Matt was discharged to regain his strength and return to the active lifestyle he valued so much.

the conclusion

Matt made it home in time to help his daughter move to college.

Within two months of his transplant, he was logging 5 miles per week on the treadmill, and he has now returned to farming, fishing, snowmobiling and enjoying thefishing outdoors with friends Matt for Gerrard trout and loved ones. on Lake Pend Oreille

8

SMIDT HEART INSTITUTE AT CEDARS-SINAI

PROGRAM DIFFERENTIATORS

→ More than 34% of patients go from listing to

transplant within 30 days, exceeding the national average

→ Novel therapeutic options in the pretransplant, perioperative and posttransplant periods to reduce organ rejection

→ Precision medicine efforts evaluating patients’

genes, environment and lifestyle for individualized treatment strategies that optimize outcomes

132

DURABLE AND TEMPORARY MECHANICAL CIRCULATORY SUPPORT DEVICES PLACED IN FY23

149

ECMO CASES IN FY23

126

HEART TRANSPLANTS IN FY23

1 600

> ,

HEART TRANSPLANTS TO DATE

→ An ex vivo perfusion (heart-in-a-box) program

that increases the number of usable organs by keeping the heart beating during transport, extending the distance a heart can be transported

→ A donation after cardiac death program, which

uses an ex vivo platform and normothermic regional perfusion to expand the donor pool and the number of heart transplants by about 25%

→ Faculty recognized for their impact in the field, including the International Society for Heart and Lung Transplantation’s 2023 Lifetime Achievement Award recipient SERVICE SPOTLIGHTS

→ Tailored immunosuppressant regimen to

Tocilizumab to Target Inflammation and Alloimmunity After Transplant for End-Stage Heart Disease Investigators at the Smidt Heart Institute continue to lead research endeavors to improve survival and outcomes for heart transplant patients and make transplant successful for the sickest patients.

They have initiated a Phase II, prospective, multicenter, randomized, placebocontrolled clinical trial investigating the effects of tocilizumab on inflammatory and alloimmune responses and defining the utility of several noninvasive biomarkers for risk assessment, diagnosis and prognostics.

transplant recipients’ unique factors

→ Multiple faculty-led clinical trials to expand patient care options

→ Routine use of statins based on our pioneering research, leading to only 5% organ rejection

→ Therapeutic options for antibody reduction in

one of the nation’s largest desensitization centers

→ Expertise in transplants for complex patients

bridged from mechanical circulatory support

RELEVANT RECENT PUBLICATIONS

Evolving trends and widening racial disparities in children listed for heart transplantation in the United States. Circulation; PMID: 35861769 2024 ANNUAL REPORT

9

LUNG TRANSPLANT Setting the Standard for Minimally Invasive Lung Transplants From performing the first robotically assisted double-lung transplant to pioneering one of the nation’s most advanced organ-rejection regimens, the Smidt Heart Institute’s cardiothoracic surgeons routinely reinvent the boundaries of modern lung transplant science.

Frank riding beside the Orange County coastline

10 SMIDT HEART INSTITUTE AT CEDARS-SINAI

PROGRAM DIFFERENTIATORS

→ Leaders in developing minimally invasive lung transplantation, using 2- to 3-inch incisions proven to reduce pain, recovery times and postoperative complications

→ Pioneers of the first robotically assisted

double-lung transplant and the only program systematically offering this technique to patients

→ Accept challenging cases refused by other centers, including patients with heart disease, previous chest surgery or prior transplantation → Leading expertise in using ECMO as a bridge to transplantation for severely ill patients

→ The only U.S. center providing in vitro

intravenous gamma globulin testing to reduce organ-rejection risk

approach to lung transplantation, I’m 60 now, so→ Individualized tailoring surgical technique to patients’ needs I’m shooting for another 15 to 20SERVICE SPOTLIGHTS Heart-lung, lung-kidney and other multiorgan years. There’s → transplants → The most advanced donor organ preservation nothing holding methods, enabling use of donor organs from me back.” anywhere in the U.S.

80

>

LUNG

TRANSPLANTS IN 2023

57 % MINIMALLY

INVASIVE IN FY23

3

ROBOTICALLY ASSISTED IN FY23

→ The most sophisticated diagnostics, including – Frank Coburn Minimally invasive double-lungventilation perfusion scans and lung diffusion capacity testing for posttransplant surveillance transplant patient Huntington Beach, California → Advanced organ compatibility profiles via in-depth blood and tissue testing RELEVANT RECENT PUBLICATIONS

Robotic-assisted lung transplantation: First in man. J Heart Lung Transplant; PMID: 37778524 Simultaneous lung-kidney transplantation in the United States.

Ann Thorac Surg; PMID: 37356520 Lung transplantation outcomes in patients from socioeconomically distressed communities. J Heart Lung Transplant; PMID: 37481047 2024 ANNUAL REPORT

11

LUNG TRANSPLANT Setting the Standard for Minimally Invasive Lung Transplants From performing the first robotically assisted double-lung transplant to pioneering one of the nation’s most advanced organ-rejection regimens, the Smidt Heart Institute’s cardiothoracic surgeons routinely reinvent the boundaries of modern lung transplant science.

the case

Frank Coburn (57) suffered from breathlessness, persistent cough and misdiagnoses for decades before additional testing uncovered interstitial lung disease.

His pulmonologist recommended Cedars-Sinai both for initial management and eventual transplant, if needed.

the care

By the time Frank arrived at Cedars-Sinai, the treatment options for his extensive pulmonary fibrosis were limited. The experts at Cedars-Sinai recommended a double-lung transplant. Frank qualified for the transplant and received a call within five days of being added to the transplant list.

In March 2021, he became the first person in the U.S. to receive a minimally invasive double-lung transplant.

the conclusion

Frank was alert and walking within hours of the transplant. Within 10 days, he was home, and within six months he had returned to riding his motorcycle. Frank and his wife have built a lasting relationship with his donor’s family—and he has maintained an active lifestyle and optimal health since the transplant.

Frank riding beside the Orange County coastline

10 SMIDT HEART INSTITUTE AT CEDARS-SINAI

PROGRAM DIFFERENTIATORS

→ Leaders in developing minimally invasive lung transplantation, using 2- to 3-inch incisions proven to reduce pain, recovery times and postoperative complications

→ Pioneers of the first robotically assisted

double-lung transplant and the only program systematically offering this technique to patients

→ Accept challenging cases refused by other centers, including patients with heart disease, previous chest surgery or prior transplantation → Leading expertise in using ECMO as a bridge to transplantation for severely ill patients

→ The only U.S. center providing in vitro

intravenous gamma globulin testing to reduce organ-rejection risk

→ Individualized approach to lung transplantation, tailoring surgical technique to patients’ needs

80

>

LUNG

TRANSPLANTS IN 2023

57 % MINIMALLY

INVASIVE IN FY23

3

ROBOTICALLY ASSISTED IN FY23

SERVICE SPOTLIGHTS

→ Heart-lung, lung-kidney and other multiorgan transplants

→ The most advanced donor organ preservation methods, enabling use of donor organs from anywhere in the U.S.

→ The most sophisticated diagnostics, including

ventilation perfusion scans and lung diffusion capacity testing for posttransplant surveillance

→ Advanced organ compatibility profiles via in-depth blood and tissue testing

RELEVANT RECENT PUBLICATIONS

Robotic-assisted lung transplantation: First in man. J Heart Lung Transplant; PMID: 37778524 Simultaneous lung-kidney transplantation in the United States.

Ann Thorac Surg; PMID: 37356520 Lung transplantation outcomes in patients from socioeconomically distressed communities. J Heart Lung Transplant; PMID: 37481047 2024 ANNUAL REPORT

11

ELECTROPHYSIOLOGY Proactively Managing Heart Rhythm Problems, From Atrial Fibrillation to Sudden Cardiac Death The combination of population data and AI tools is transforming the future of cardiology, allowing physicians to predict the nature of heart rhythm problems so they can devise effective prevention strategies. Once arrhythmias manifest, the Smidt Heart Institute offers the full range of treatment options, from ablation to experimental regenerative approaches.

Claudia preparing for a bodybuilding competition

12 SMIDT HEART INSTITUTE AT CEDARS-SINAI

PROGRAM DIFFERENTIATORS

→ Embrace new developments in the field,

including smart detection of AFib and ventricular arrythmias as well as AI analysis that predicts arrhythmia events

→ Improve prediction capabilities for sudden cardiac arrest beyond the status quo via investigator-initiated studies

→ Lead research that changes conventional wisdom about common heart rhythm conditions SERVICE SPOTLIGHTS

→ Unite clinical expertise and scientific research in

Eliminating the Unknowns in Cardiology Contrary to conventional wisdom on AFib, women— when height is accounted for—have a 50% higher risk of developing the abnormal heart rhythm disturbance than men, suggesting AFib prevention and intervention should be emphasized in patients of both sexes. JAMA Cardiol; PMID: 36044209

the Center for Cardiac Arrest Prevention

→ Employ cutting-edge 3D mapping and catheter ablation technology for treatment of atrial and ventricular arrhythmias

I was scared, but → Implant leadless pacemakers and strokethe way my doctor prevention devices explained the → Treat even the rarest and most complex with genetic testing and tailored procedure madearrhythmias management as appropriate me feel very RELEVANT RECENT PUBLICATIONS comfortable, very How to minimize in-hospital mortality from acute myocardial secure. He was infarction: Focus on primary prevention of ventricular fibrillation.

Eur Heart J; PMID: 36378508 confident, and that First-line catheter ablation for paroxysmal atrial fibrillation— Have we reached the tipping point? N Engl J Med; PMID: made me feel like, 36630626 OK, I can trust you.”

Polygenic risk score predicts sudden death in patients with coronary disease and preserved systolic function. J Am Coll – Claudia Huerta Cardiol; PMID: 36007985 Paroxysmal AFib/flutter patient Warning symptoms associated with imminent sudden cardiac Maywood, California arrest: A population-based case-control study with external validation. Lancet Digital Health; PMID: 37640599

2024 ANNUAL REPORT 13

ELECTROPHYSIOLOGY Proactively Managing Heart Rhythm Problems, From Atrial Fibrillation to Sudden Cardiac Death The combination of population data and AI tools is transforming the future of cardiology, allowing physicians to predict the nature of heart rhythm problems so they can devise effective prevention strategies. Once arrhythmias manifest, the Smidt Heart Institute offers the full range of treatment options, from ablation to experimental regenerative approaches.

the case

Claudia Huerta (44) experienced high resting heart rates, fatigue and dizziness, which prompted her to schedule a visit with her primary care physician. Follow-up monitoring with Cedars-Sinai resulted in a diagnosis of hereditary paroxysmal atrial fibrillation (AFib)/flutter (13% burden).

the care

Recommended treatment included lifestyle modification with regular exercise, weight loss and elimination of alcohol. Claudia committed to a rigorous exercise and dietary program and elected to undergo AFib/flutter catheter ablation rather than taking pills for the rest of her life. The ablation was completed in November 2021 with no complications.

the conclusion

Claudia maintained her lifestyle modifications and has lost 80 pounds since diagnosis. She competes in high-level bodybuilding competitions without the use of supplements.

She has been free of AFib since the ablation, is off all cardiac medications and will continue with annual monitoring.

Claudia preparing for a bodybuilding competition

12 SMIDT HEART INSTITUTE AT CEDARS-SINAI

PROGRAM DIFFERENTIATORS

→ Embrace new developments in the field,

including smart detection of AFib and ventricular arrythmias as well as AI analysis that predicts arrhythmia events

→ Improve prediction capabilities for sudden cardiac arrest beyond the status quo via investigator-initiated studies

→ Lead research that changes conventional wisdom about common heart rhythm conditions SERVICE SPOTLIGHTS

→ Unite clinical expertise and scientific research in

Eliminating the Unknowns in Cardiology Contrary to conventional wisdom on AFib, women— when height is accounted for—have a 50% higher risk of developing the abnormal heart rhythm disturbance than men, suggesting AFib prevention and intervention should be emphasized in patients of both sexes. JAMA Cardiol; PMID: 36044209

the Center for Cardiac Arrest Prevention

→ Employ cutting-edge 3D mapping and catheter ablation technology for treatment of atrial and ventricular arrhythmias

→ Implant leadless pacemakers and strokeprevention devices

→ Treat even the rarest and most complex

arrhythmias with genetic testing and tailored management as appropriate

RELEVANT RECENT PUBLICATIONS

How to minimize in-hospital mortality from acute myocardial infarction: Focus on primary prevention of ventricular fibrillation.

Eur Heart J; PMID: 36378508 First-line catheter ablation for paroxysmal atrial fibrillation— Have we reached the tipping point? N Engl J Med; PMID: 36630626 Polygenic risk score predicts sudden death in patients with coronary disease and preserved systolic function. J Am Coll Cardiol; PMID: 36007985 Warning symptoms associated with imminent sudden cardiac arrest: A population-based case-control study with external validation. Lancet Digital Health; PMID: 37640599

2024 ANNUAL REPORT 13

CONGENITAL HEART Accredited, Collaborative Care Across the Life Continuum The Smidt Heart Institute’s Adult Congenital Heart Disease (ACHD) Program is one of only 50 programs in the nation to achieve the prestigious ACHD Accredited Comprehensive Care Center designation. Our philosophy: one-stop care from intrauterine life through adulthood, even for the most complex congenital heart disorders.

Tim cherishing family time

14 SMIDT HEART INSTITUTE AT CEDARS-SINAI

PROGRAM DIFFERENTIATORS

→ Seamless, comprehensive congenital cardiac care, from conception to advanced age

→ One of only a handful of centers around

the world to offer minimally invasive valve reconstruction for any of the four cardiac valves to patients of all ages

→ First institution to develop a bedside technique for minimally invasive patent ductus arteriosus closure in severely premature infants

→ First-in-man novel percutaneous pulmonic valve replacement

→ Multispecialty maternal-fetal care for ACHD patients through our collaborative High-Risk Pregnancy Program

→ Expertise in highly complex and challenging

congenital heart care, including advanced I went from feeling electrophysiology, interventional catheterization, that I was goingcardiac surgery, and heart and multiorgan transplantation to die—leaving→my Advanced testing, including multiplanar 3D wife as a widow imaging and to visualize complex congenital anatomy, exercise testing, cardiac nuclear studies, fetal my kids withoutcardiac a evaluation and cardiogenetic counseling father—to havingSERVICE a SPOTLIGHTS rich, full life with → Identify and manage congenital heart valve decades of hope disorders and in complex structural heart defects, expectations.” → Expertise including hypoplastic left heart syndrome, – Tim Fitzgerald Ross procedure patient Riverside, California

3 77

DAYS

TO

YEARS

YOUNGEST AND OLDEST PATIENTS TO DATE

100% PROVIDER

SATISFACTION SCORE

0

30-DAY MORTALITY FOR >3 YEARS

190

CONSECUTIVE CASES (AND COUNTING) WITH NO 30-DAY SURGICAL MORTALITIES

tetralogy of Fallot, transposition of the great arteries and coronary artery fistula

→ Multidisciplinary care for adult conditions complicated by ACHD

→ Monitor and treat arrhythmias associated with congenital heart disease

2024 ANNUAL REPORT

15

CONGENITAL HEART Accredited, Collaborative Care Across the Life Continuum The Smidt Heart Institute’s Adult Congenital Heart Disease (ACHD) Program is one of only 50 programs in the nation to achieve the prestigious ACHD Accredited Comprehensive Care Center designation. Our philosophy: one-stop care from intrauterine life through adulthood, even for the most complex congenital heart disorders.

the case

Tim Fitzgerald (37) was referred to the Smidt Heart Institute after an attempt to address congenital aortic valve stenosis at another hospital failed due to a hostile chest cavity.

the care

Preoperative imaging confirmed Tim was not a candidate for transcatheter aortic valve replacement (TAVR). He underwent a Ross procedure to replace his diseased aortic valve with his own pulmonary valve, which was, in turn, replaced with a pulmonary allograft. He did well intraoperatively and recovered quickly.

the conclusion

The care team expects Tim’s successful surgery to provide him with a future free from openheart surgery, unlike alternative treatments often used for congenital aortic valve stenosis, which typically require lifelong anticoagulation or reoperation in 10-25 years. One year after the procedure, Tim is healthy, thriving and enjoying his time as an active and engaged husband and father of three young children.

Tim cherishing family time

14 SMIDT HEART INSTITUTE AT CEDARS-SINAI

PROGRAM DIFFERENTIATORS

→ Seamless, comprehensive congenital cardiac care, from conception to advanced age

→ One of only a handful of centers around

the world to offer minimally invasive valve reconstruction for any of the four cardiac valves to patients of all ages

→ First institution to develop a bedside technique for minimally invasive patent ductus arteriosus closure in severely premature infants

→ First-in-man novel percutaneous pulmonic valve replacement

→ Multispecialty maternal-fetal care for ACHD patients through our collaborative High-Risk Pregnancy Program

→ Expertise in highly complex and challenging

congenital heart care, including advanced electrophysiology, interventional catheterization, cardiac surgery, and heart and multiorgan transplantation

→ Advanced testing, including multiplanar 3D

imaging to visualize complex congenital anatomy, exercise testing, cardiac nuclear studies, fetal cardiac evaluation and cardiogenetic counseling SERVICE SPOTLIGHTS

→ Identify and manage congenital heart valve disorders

→ Expertise in complex structural heart defects,

3 77

DAYS

TO

YEARS

YOUNGEST AND OLDEST PATIENTS TO DATE

100% PROVIDER

SATISFACTION SCORE

0

30-DAY MORTALITY FOR >3 YEARS

190

CONSECUTIVE CASES (AND COUNTING) WITH NO 30-DAY SURGICAL MORTALITIES

including hypoplastic left heart syndrome, tetralogy of Fallot, transposition of the great arteries and coronary artery fistula

→ Multidisciplinary care for adult conditions complicated by ACHD

→ Monitor and treat arrhythmias associated with congenital heart disease

2024 ANNUAL REPORT

15

AORTIC DISEASES Devices and Collaboration to Treat Aortic Disease Care at the Smidt Heart Institute doesn’t stop at the heart. Our experts routinely manage cases ranging from acute dissections to chronic aneurysms of the aorta.

Leading the way in clinical trials, novel devices and minimally invasive care, the collaborative team at the Smidt Heart Institute at Cedars-Sinai is reimagining aortic care.

Eduardo cooking on the mountain top

16 SMIDT HEART INSTITUTE AT CEDARS-SINAI

PROGRAM DIFFERENTIATORS

→ Early consultation and seamless collaboration between referring physicians and surgeons

→ Experts in complex treatment, including open and endovascular aortic repair

→ Leaders in clinical trials and investigational

devices, including branched devices for the aortic arch and thoracoabdominal aorta

→ Advanced imaging techniques to evaluate the

implications of aneurysms in individual patients

→ A holistic approach to aneurysm management throughout the lifespan, including skilled care during pregnancy and nonaortic surgeries as well as lifestyle and genetic counseling

→ Recognized by the Marfan Foundation as a center

with expertise in the comprehensive care of individuals with genetic aortic and vascular conditions

I don’t want to leave California.SERVICE SPOTLIGHTS I’m getting my →heart Experts in minimally invasive (endovascular) aortic repair, including ascending, arch and care here forever. thoracoabdominal aortic repair; endovascular The way they closed aneurysm repair; thoracic endovascular aortic repair; and fenestrated endovascular aortic my wound, it was repair for minimally invasive aortic aneurysm beautiful. The and dissection management → Comprehensive management of aortic Cedars-Sinai facility aneurysms, dissections, transections, infections, disorders, connective tissue is top notch, andinflammatory diseases, and ulcers and fistulas the nurses are →soExpertise in the Ross procedure, valve-sparing experienced.” root replacement and aortic valve repair

The Hidden World of Aortic Aneurysms Cedars-Sinai physicians are investigating the genetic mechanisms of aortic aneurysms and dissections using myriad approaches, including image analysis via AI. Nat Rev Cardiol; PMID: 36131050 — Enrolling for ARISE in 2024 This clinical trial is designed to investigate minimally invasive endovascular repair of ascending aortic lesions.

– Eduardo Grande RELEVANT RECENT PUBLICATIONS Thoracoabdominal aortic aneurysm patient Impact of cerebral perfusion on outcomes of aortic surgery: Los Angeles, California The Society of Thoracic Surgeons Adult Cardiac Surgery database analysis. Ann Thorac Surg; PMID: 31563489

2022 ACC/AHA guideline for the diagnosis and management of aortic disease: A report of the American Heart Association/ American College of Cardiology Joint Committee on Clinical Practice Guidelines. J Thorac Cardiovasc Surg; PMID: 37389507 2024 ANNUAL REPORT

17

AORTIC DISEASES Devices and Collaboration to Treat Aortic Disease Care at the Smidt Heart Institute doesn’t stop at the heart. Our experts routinely manage cases ranging from acute dissections to chronic aneurysms of the aorta.

Leading the way in clinical trials, novel devices and minimally invasive care, the collaborative team at the Smidt Heart Institute at Cedars-Sinai is reimagining aortic care.

the case

Eduardo Grande (39) is a Marfan syndrome patient with prior mechanical Bentall and ascending arch replacement, open infrarenal abdominal aortic aneurysm repair, open arch repair with innominate and left common carotid debranching, and elephant trunk. He presented with an 8.3-centimeter thoracoabdominal aortic aneurysm.

the care

Eduardo’s cardiac and vascular surgeons collaborated perioperatively on a staged hybrid repair of the extent II thoracoabdominal aneurysm.

They performed a left carotid– subclavian artery bypass, coiled the left subclavian artery and repaired the proximal thoracic aorta using minimally invasive thoracic endovascular aortic repair (zones 2-5). Then, they performed an open extent IV thoracoabdominal aortic aneurysm repair, using left-heart bypass with sequential clamping and individual anastomosis.

the conclusion

Eduardo cooking on the mountain top

16

Eduardo returned home nine days after the procedure. Two months after surgery, he had returned to most of his daily activities, including fixing his Jeep, cooking, camping and off-roading with family and friends.

PROGRAM DIFFERENTIATORS

→ Early consultation and seamless collaboration between referring physicians and surgeons

→ Experts in complex treatment, including open and endovascular aortic repair

→ Leaders in clinical trials and investigational

devices, including branched devices for the aortic arch and thoracoabdominal aorta

→ Advanced imaging techniques to evaluate the

implications of aneurysms in individual patients

→ A holistic approach to aneurysm management throughout the lifespan, including skilled care during pregnancy and nonaortic surgeries as well as lifestyle and genetic counseling

→ Recognized by the Marfan Foundation as a center

with expertise in the comprehensive care of individuals with genetic aortic and vascular conditions

The Hidden World of Aortic Aneurysms Cedars-Sinai physicians are investigating the genetic mechanisms of aortic aneurysms and dissections using myriad approaches, including image analysis via AI. Nat Rev Cardiol; PMID: 36131050 — Enrolling for ARISE in 2024 This clinical trial is designed to investigate minimally invasive endovascular repair of ascending aortic lesions.

SERVICE SPOTLIGHTS

→ Experts in minimally invasive (endovascular)

aortic repair, including ascending, arch and thoracoabdominal aortic repair; endovascular aneurysm repair; thoracic endovascular aortic repair; and fenestrated endovascular aortic repair for minimally invasive aortic aneurysm and dissection management

→ Comprehensive management of aortic

aneurysms, dissections, transections, infections, inflammatory disorders, connective tissue diseases, and ulcers and fistulas

→ Expertise in the Ross procedure, valve-sparing root replacement and aortic valve repair

RELEVANT RECENT PUBLICATIONS

Impact of cerebral perfusion on outcomes of aortic surgery: The Society of Thoracic Surgeons Adult Cardiac Surgery database analysis. Ann Thorac Surg; PMID: 31563489 2022 ACC/AHA guideline for the diagnosis and management of aortic disease: A report of the American Heart Association/ American College of Cardiology Joint Committee on Clinical Practice Guidelines. J Thorac Cardiovasc Surg; PMID: 37389507 2024 ANNUAL REPORT

17

VASCULAR DISORDERS Comprehensive, Multidisciplinary Vascular Care From minimally invasive carotid artery stents to the most complex aortic and limbpreservation procedures, the Vascular Surgery division at the Smidt Heart Institute at Cedars-Sinai offers robust, collaborative care backed by the latest in technology and medical science.

— Converging on Predictive, Personalized Medicine An institutional grant supports ongoing biomarker and mechanistic studies using patient surgical tissue to better predict aortic aneurysms and dissections.

This work complements ongoing clinical outcomes research, basic and animal model work, and AI tools to advance our understanding of risk factors, early diagnosis options, and potential treatment and preventive pathways for catastrophic aortic conditions.

100% SUCCESS RATE FOR

ENDOVASCULAR AORTIC INTERVENTIONS IN FY23

18 SMIDT HEART INSTITUTE AT CEDARS-SINAI

PROGRAM DIFFERENTIATORS

→ Provide minimally invasive transcarotid artery

revascularization hybrid stent to help prevent or treat strokes in patients with carotid blockage

→ Aggressive growth in satellite locations to accommodate the increasing volume of complex procedures

→ Leading program for thoracic branch endoprosthesis implant clinical trials

→ Offer the thoracoabdominal branch

endoprosthesis (TAMBE) study examining the safety and efficacy of the device for minimally invasive treatment of thoracoabdominal aortic aneurysms

→ Investigator-initiated basic research on diverse vascular topics such as proteomics and dissection risk prediction, with an in-progress biobank of surgical tissue SERVICE SPOTLIGHTS

→ Major destination for minimally invasive and

complex open aortic surgery as well as care involving approved and investigational devices

→ Multidisciplinary, collaborative care in limb

salvage—with vascular surgery, podiatry, plastic surgery and cardiology teams—to save legs from amputation, including complex openbypass procedures and minimally invasive methods to provide better blood flow and improved quality of life

RELEVANT RECENT PUBLICATIONS

Differentiation between descending thoracic aortic diseases using machine learning and plasma proteomic signatures.

In press; PMID: 37162892 Initial experience with a modified “candy-plug” technique for false lumen embolization in chronic type B aortic dissection.

J Vasc Surg Cases Innov Tech; PMID: 37152918

CONTACT US If you have a patient you would like to refer to one of our programs, please contact us at 310-423-3300 or heartinstitute@cshs.org. Our physicians will partner with you to understand and address the unique needs of your patient.

If you prefer to speak directly with one of our specialists, you can also use the numbers below.

Aortic Disease 310-423-3851 Identifies and treats diseases that affect the aorta and provides access to groundbreaking surgical techniques and clinical trials

Heart Transplant 310-423-5460 Leads the nation in providing advanced cardiac support devices, surgical techniques and anti-rejection technologies

The Guerin Family Congenital Heart Program 310-423-1153 Offers state-of-the-art treatment for congenital heart patients from birth through adulthood

Hypertension 310-423-2726 Provides multispecialty evaluation and management of complex hypertension through an American Society of Hypertension-certified Hypertension Center of Excellence

Coronary Disease 310-423-3300 The most advanced imaging, medical and procedural care for ischemic heart disease

Atrial Fibrillation (AFib) 424-315-4413 Offers the most advanced diagnostic and treatment protocols for AFib

Electrophysiology 310-248-6679 Provides state-of-the-art technology for patients with abnormal heart rhythms

California Heart Center 310-248-8300 Provides a full range of cardiology care, including interventional cardiology, nuclear cardiology, echocardiography and hypertension management

General and Preventive Cardiology 310-423-2726 Provides the highest-quality care for preventing, detecting and treating heart disease Heart Failure and Cardiomyopathy 310-423-2077 Provides a comprehensive assessment and treatment plan for people with congestive heart failure and all types of heart muscle disease

Cardio-Oncology 310-423-2726 Offers specialized cardiovascular care to cancer survivors and patients undergoing cancer treatment Cardiogenetics 310-423-2726 Treats familial cardiac conditions with a multidisciplinary approach, including cardiology, genetics and risk assessment ILLUSTRATION: CAROLINE TOMLINSON

Cardiac Surgery 310-423-3851 Provides leading-edge cardiac surgery, including minimally invasive and complex cardiac surgical procedures

|

DESIGN: STUDIODELUXE.COM

Interventional Cardiology 310-423-3977 Treats coronary and valvular heart disease using innovative nonsurgical techniques Lipid Disorders 310-423-2726 Provides a full range of diagnostics and treatments for patients with cholesterol and triglyceride disorders Mechanical Circulatory Support 310-423-7338 Offers complete care for patients with heart failure, including mechanical devices that help the heart pump blood Mitral Disease 310-423-3300 Offers expert imaging, interventional and surgical approaches to mitral disease

Preventive and Rehabilitative Cardiac Center 310-423-9660 Provides cardiology patients with tools to improve their health and fitness, including monitored exercise programs, nutrition advice and stress management Regenerative Medicine 310-423-1231 Provides the most extensive experience worldwide in cardiac stem cell therapy, including more than 10 different cell types and methods of delivery Robotic Cardiac Surgery 310-423-3851 National leaders in robotic mitral repair and coronary surgery Valvular Heart Disease 844-432-7805 Provides novel, minimally invasive procedures to repair and replace heart valves Vascular Surgery 310-423-5400 Provides diagnosis and management of all arterial and venous disorders and offers a full spectrum of advanced open, endovascular and hybrid procedures Women’s Heart Disease, Barbra Streisand Women’s Heart Center 310-423-9680 Plays a leading role in identifying female-pattern heart disease, developing diagnostic tools and advancing specialized care for women

2024 ANNUAL REPORT

19

METRICS / PATIENT CARE

1

#

IN CALIFORNIA

(highest U.S. News & World Report ranking in the region)

2

#

OUTCOMES

ALL PROCEDURES FY23

30-day risk-adjusted mortality July-Dec. 2019 and July 2020-June 2022

TOTAL

HEART FAILURE

185 ,133

CARDIAC CATHETERIZATIONS

6.9 % 11.8 %

12 ,794

ELECTROPHYSIOLOGY PROCEDURES

2, 271

CEDARS-SINAI

CARDIAC SURGERIES

2 ,285

ADVANCED IMAGING

17,319

NATIONAL

IN THE NATION

29,156 PCI

9,515 MITRACLIP

968

TRICUSPID CLIP

231

ABLATION PROCEDURES

3,015

PERCUTANEOUS LVAD

9.2 % 12.6 %

CEDARS-SINAI

NATIONAL

OUTPATIENT VISITS FY19–FY23

385

40,009

ANGIOGRAPHY

34, 208

FY19–FY23

150,464

HEART ATTACK

35,865

CARDIAC INTERVENTIONS

NONINVASIVE DIAGNOSTICS

45, 258 46, 315

RANKINGS 2023-24

PERCUTANEOUS CLOSURE OF LEFT ATRIAL APPENDAGE OCCLUSION

809

20 SMIDT HEART INSTITUTE AT CEDARS-SINAI

FY19

FY20

FY21

FY22

FY23

METRICS / RESEARCH CARDIAC SURGERIES FY19-FY23

CLINICAL TRIALS FY23

INTELLECTUAL PROPERTY TO DATE

HEART AND LUNG TRANSPLANTATION AND MECHANICAL CIRCULATORY SUPPORT

ENROLLING

HEART TRANSPLANT

FOLLOW-UP PHASE

303

EXTRACORPOREAL MEMBRANE OXYGENATION

625

ROBOTIC CARDIAC SURGERY ROBOTIC MITRAL REPAIR

593

ROBOTIC CORONARY REVASCULARIZATION

150

U.S. PATENTS ISSUED

TOTAL

INTERNATIONAL PATENT APPLICATIONS FILED

53

393

FY19

FY21

$37,905,494

PEER-REVIEWED ARTICLES FY19–FY23

$39,729,490

$16,620,202

$44,487,383

FY22

$18,924,840

TAVR

3,162

$45,780,136

FY23

763

12

$36,722,750

$14,035,658

AORTIC VALVE RECONSTRUCTION (repair, valve sparing and replacements)

THORACIC AORTIC OPEN AND ENDOVASCULAR SURGERY

COPYRIGHT REGISTRATIONS

$ 11,178,685

MITRAL VALVE RECONSTRUCTION (repair and replacements)

AORTA, CORONARY AND OTHER CARDIAC SURGERY

86

RESEARCH FUNDING FY19–FY23

VALVULAR HEART SURGERY

1,103

207

INTERNATIONAL PATENTS ISSUED

FY20

1,102

83

582

290

SOON TO ENROLL

527

VENTRICULAR ASSIST DEVICES AND TOTAL ARTIFICIAL HEARTS

166

467

226

425

LUNG TRANSPLANT (SINGLE AND MULTIORGAN)

U.S. PATENT APPLICATIONS FILED

388

605

174

$18,890,878

National Institutes of Health (NIH)

FY19

FY20

FY21

FY22

CORONARY REVASCULARIZATION

1,159

OTHER (adult congenital, septal myectomy, pericardiectomy)

161

PHILANTHROPY

1,176

DONORS SUPPORTED THE SMIDT HEART INSTITUTE IN FY23

16

ENDOWED CHAIRS

FY23

Smidt Heart Institute 127 S. San Vicente Blvd.

Suite A3600 Los Angeles, CA 90048

Nonprofit Org. U.S. Postage PAID Los Angeles, CA Permit No. 22328

heartinstitute@cshs.org

1 2

#

#

IN CALIFORNIA (HIGHEST U.S. NEWS RANKING IN THE REGION)

IN THE U.S. FOR CARDIOLOGY, HEART & VASCULAR SURGERY

LEARN MORE ABOUT WHAT MAKES CEDARS-SINAI THE PREMIER DESTINATION FOR HEART CARE.

cedars-sinai.org/heart