Repairing ValvesReplacing ValvesSaving Lives

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Cardiac Valve Surgery and Interventional Cardiology

VANDERBILT VALVE PROGRAM

Cardiac Valve SurgeryThe surgical treatment of diseased heart valves has seen manyadvances in the past several years. Vanderbilt Heart is proudto be a leader in this field. We offer our patients the latestinnovations in cardiac valve surgery. Most of these surgeriesare performed on the aortic or mitral valves. These valvesare the inflow and outflow valves respectively, of the leftventricle which receives blood from the lungs and pumpsblood to the entire body. The tricuspid and pulmonic valvesare on the right side of the heart.

The Cardiac Valve Program unites a multidisciplinaryteam of cardiologists, cardiac surgeons and cardiacanesthesiologists trained in diagnosing and treating alldisorders of cardiac valves. If surgery is the best option fora patient, Vanderbilt surgeons perform all types of cardiacvalve procedures including aortic, mitral, pulmonary andtricuspid valve surgery. When minimally invasive surgery isappropriate, patients often have less pain and recoverquicker than with traditional surgery.

Vanderbilt Heart. A Pioneer in Valve Surgery.Vanderbilt Heart has developed a new model forcardiovascular care. In our image-guided surgery program,we utilize a hybrid operating suite where patients undergoimage-guided open-heart procedures. An angiogram can beperformed immediately after surgery within the same suite.This allows physicians to use real-time imaging to help guidethe conduct of the operation, ensuring the most completeand ideal results possible.

The hybrid operating suite allows the Vanderbilt team toperform minimally invasive valve surgery in the presence ofcoronary atherosclerotic disease (CAD) by usingpercutaneous intervention, such as angioplasty and stenting,instead of CABG surgery. Vanderbilt is one of the select fewhospitals in the region to offer percutaneous valvuloplasty(also called valvotomy) to treat mitral stenosis, aortic valvestenosis and pulmonary valve stenosis.

TYPES OF VALVE SURGERY

Valve surgery involves two major categories - valvereplacement and valve repair. Valve replacement involvesremoving the native valve and replacing it with an artificialvalve made of either mechanical parts or biological tissues.The choice between a mechanical valve vs. a biological valveis based on many factors, including patient preference,patient co-morbidities and life expectancy.

TYPES OF PROSTHETIC VALVES USED

IN VALVE REPLACEMENT

Mechanical ValvesThese artificial valves are made ofgraphite and pyralytic carbon, orother synthetic materials, which arenon-reactive and tolerated well in thehuman body. While designed to last aslong as 30 years, mechanical valvesrequire lifelong blood thinningmedications to avoid blood clotsforming on the valve which can causestroke and other complications. Because of the need forlife-long blood thinning medications, patients with amechanical valve carry a higher risk of bleedingcomplications following surgery.

Biologic (Tissue) ValvesThese valves are made from animaltissue (pig or cow) or a donatedhuman heart.

The animal tissue valves are sterilizedand chemically treated for human useand sewn onto a frame (stented) orleft intact (stentless). They lastapproximately 10-20 years or longer,depending on the age of the patient at implant.However, these valves may wear out over time and needre-replacement, particularly in younger patients. Long-termblood thinning medications are not required following valvereplacement with biological valves, but may be neededin the first 4-6 weeks following the surgery.

Mechanical Valve

Biological Valve

AORTIC VALVE SURGERY

Mechanical vs. Biological Aortic Valve ReplacementMechanical valves are typically recommended for youngerpatients who can safely take blood-thinning medications,while biological valves are often used in older patients.

A typical patient in whom a mechanical valve may beindicated would be a patient in their 40s or 50s, in whom acongenitally bicuspid or calcific valve has becomedysfunctional. Such a patient may wish to avoid repeatsurgery in 10-15 years, but accept the low but finite risk oflifelong blood thinning medication. This decision is basedon an understanding of the long-term risk of each choice.This is the balance between the risk of lifelong bloodthinning medication and its potential complications versusthe risk of reoperation if a biological valve is chosen.

A typical patient in whom a biological valve may be indicatedwould be a patient who wishes to avoid lifelong bloodthinning medication, but who accepts the risk of reoperationin 10-15 years, depending on the age of the patient atimplant. Older patients (>60-65 years), however, shouldprobably receive a biological valve because it lasts longer inolder patients. Biological valves are also typically used inwomen of childbearing age to avoid blood thinningmedications, which can cause birth defects.

TYPES OF AORTIC VALVE PROCEDURES

Aortic Valve ReplacementAortic valve surgery (replacement) is performed to treat thenarrowing (stenosis) and/or leakage (regurgitation) of theaortic valve. It is also used for infective endocarditis.The majority of diseased aortic valves require replacement,with the original valve removed and a new valve sewn tothe annulus.

Other Aortic Valve Procedures

Root Enlarging Procedure: particularly effective in smalleraortic valves

Aortic Root Replacement: typically used for connectivetissue disorders, large aortic root aneurysms, endocarditis oraortic dissections, and valve-sparing root surgery

Valve-Sparing Root: usually used for young patients withintact aortic valves, with isolated disease of the aortic root,who wish to avoid long-term blood thinning medication

BIOLOGICAL AORTICVALVE REPLACEMENT

Stented Biological Aortic ValvesStented biological valves are by far the most commonbiological valve used in aortic valve replacement. They areeither porcine valves removed from pig hearts, treated andmounted on an artificial stent(see illustration), or bovine valvesmade of cow pericardium which isalso mounted on a stent. Both porcineand bovine valves have a long trackrecord of excellent performanceand durability, particularly inolder patients.

Stented BiologicalAortic Valve

Stentless Biological Aortic ValvesStentless valves are biological valvesfrom pigs (xenograft) or humancadavers (homograft), which aretreated and structured such that theydo not need a stent. These valves aretechnically more challenging to placeinto patients, but they have certainadvantages in selected patients.

These valves are useful in patients inwhom a smaller stented valve may not provide adequateperformance because of the high gradient across thereplaced valve. Stentless valves perform more like our ownnative valves, but have limited durability, particularly inyounger patients.

Homografts(Human Cadaver Valve)A homograft valve is a valve that wasremoved from a donated humanheart, preserved, treated withantibiotics and frozen under sterileconditions. This is one of the idealvalve options for aortic valvereplacement in the setting of infectiveendocarditis. Homograft valve can beplaced using either full root techniqueof sub coronary methods. They lastabout 10-20 years.

Stentless BiologicalAortic Valve

Homograft Valve

AORTIC ROOT REPLACEMENT

When the entire aortic root is diseased, or when aortic rootreplacement is deemed preferable for isolated aortic valvereplacement (see illustration), aortic root replacement isperformed. It involves thereplacement of not only the aorticvalve, but also the aortic sinus tissuedown to the valve. It also requiresreimplantation of the coronaryarteries. A composite valved conduit(mechanical or biological) includes anew valve as well as new aortic tissue.This procedure is typically used forconnective tissue disorders such asMarfan syndrome, large aortic rootaneurysms, endocarditis or aorticdissections. The choice between mechanical vs. biologicalaortic root replacement is based on factors similar toisolated aortic valve replacement.

VALVE SPARING ROOT SURGERY(SPARING THE NATIVE VALVE)

In valve sparing root surgery, the native valve is preservedand a tube graft is used to replace the diseased aorta.This often requires that the native aortic valve has preservedfunction (no significant leakage). If the native valve isdysfunctional, a fullroot replacementis often needed.Valve sparing rootsurgery is typicallyperformed for youngpatients with intactaortic valves, withisolated diseases ofthe aortic root, whowish to avoid long-term blood thinningmedication.

Root Replacement

Valve-Sparing Root

MITRAL VALVE SURGERY

This surgery is typically performed formitral valve stenosis (narrowing) fromrheumatic heart disease. It is also usedto repair regurgitation (leakage) or forinfective endocarditis. Most diseasedmitral valves can be repaired, butreplacement is occasionally needed.Like the valves in aortic valvereplacement, they can be mechanicalor biological. However, biologicalvalves in the mitral position oftendo not last as long as in theaortic position.

TYPES OF MITRAL

VALVE REPAIR

Valve repair allows a surgeon toreconstruct a faulty valve using thepatients’ own tissue. The advantages ofheart valve repair are lower risk ofinfection, decreased need for life-long blood thinner medications andpreserved heart muscle strength.

Common Valve Repairs

Leaflet Repair: leaflets are repairedby patching of holes or tears in valveleaflets, and/or by reconstructing leaflets to rebuild thenative valve. (see illustrations A-C)

Ring Annuloplasty: a ring is attached to the tissue aroundthe valve to provide the needed support so that the valve canclose tightly. (see illustration D)

TRICUSPID VALVE SURGERY

The majority of tricuspid valve disorders are due to leakageand can be safely repaired. There are multiple repairtechniques, each with certain advantages. Some are as simpleas “bicuspidalization” of the valve with a single suture, whileothers involve placement of a suture or ring around theannulus. Tricuspid valve replacement is occasionally neededin cases of severe tricuspid valve disease.

A.

B.

C.

D.

Mitral Valve Surgery

MINIMALLY INVASIVEHEART VALVE SURGERY

Minimally invasive heart valve surgery is performed througha small incision in the chest wall. Benefits from this type ofprocedure include faster recovery withless pain. Minimally invasive valveoperations are performed through anupper mini-sternotomy (AorticValve), or a small right thoracotomy(Mitral Valve).

Minimally Invasive AorticValve SurgeryAortic valve replacement can beperformed through an incision 6 cmin length to open the upper part ofthe sternum.

Minimally Invasive MitralValve SurgeryMitral valve and tricuspid valve repairsand replacements can be performedthrough a 5-7 cm incision in theright chest.

INTERVENTIONAL CARDIOLOGY

Percutaneos Mitral Valvuloplasty: Symptomatic mitral valvestenosis (narrowing) can be treated with balloonvalvuloplasty, which has emerged as an alternative to surgery.During valvuloplasty, a thin catheter (tube) with a balloontip is used to stretch or open the narrowed mitral valve.The catheter, threaded from the groin, is guided into placeby X-ray and ultrasound (Echocardiography). Theprocedure, which is done in the cardiac catheterizationlaboratory, takes 1-2 hours and requires an overnighthospital stay.

Percutaneous Aortic Valvuloplasty: Although aortic valvereplacement is the treatment of choice for aortic valvestenosis, percutaneous balloon aortic valvuloplasty can beused as a bridge to aortic valve replacement in selected highrisk patients, in patients undergoing emergent non-cardiacsurgery, and in patients who are too ill to undergo cardiac

Minimally InvasiveAortic Valve Surgery

Minimally InvasiveMitral Valve Surgery

surgery. It may represent the onlytreatment for some frail elderlypatients or treatment of choice incertain adolescent congenital defects.In balloon aortic valvuloplasty, aballoon catheter is placed through thevalve and expanded in order toincrease the opening size of the valveand improving blood flow.

Vanderbilt Heart and Vascular Institute has amultidisciplinary (Interventional Cardiology, CardiacSurgery, Cardiac Imaging, and Cardiac Anesthesia) teamthat is experienced in these procedures and is the onlyhospital in the region to perform such procedures.

KEEPING THE HEART PUMPING

IS OUR PASSION

The Cardiac Valve Program at Vanderbilt is committed tohelping its patients determine the optimal treatment fortheir valve condition. Whether this treatment involvesmedical therapies alone or surgery, our goal is to treat everypatient like they are our only patient. That’s why we give careto one person and one heart at a time.

VALVE CLINIC

The Vanderbilt Heart Valve Clinic is a multidisciplinaryteam of physicians and surgeons who evaluate unique heartvalve patients on Wednesdays. They follow this clinic with acomprehensive valve conference on Thursday mornings toreview the unique cases and determine the most appropriatetreatment plan. The team will then communicate the plan tothe patient and referring physician and arrange follow-upas needed.

PercutaneousAortic Valvuloplasty

John G. Byrne, M.D.William S. Stoney Professor of Cardiac SurgeryChairman, Department of Cardiac SurgeryM.D. Degree: Boston University, 1987Post-Graduate Training: University of Illinois AffiliatedHospitals, Chicago; Harvard Medical School, Boston; Brigham andWomen’s Hospital, Harvard Medical School, Boston

Tarek S. Absi, M.D.Assistant Professor of Cardiac SurgeryM.D. Degree: American University of Beirut, 1995Post-Graduate Training: North Shore University Hospital,NYU School of Medicine, Manhasset; University School ofMedicine, St Louis; Vanderbilt University Medical Center,Nashville; Brigham and Women's Hospital, Harvard MedicalSchool, Boston

Rashid M. Ahmad, M.D.Assistant Professor of Cardiac SurgeryM.D. Degree: College of Physicians and Surgeons, ColumbiaUniversity, 1992Post-Graduate Training: The Cleveland ClinicFoundation, Cleveland; Harvard Medical School, Boston; The NewYork Hospital-Cornell Medical Center, New York

Jorge M. Balaguer, M.D.Assistant Professor of Cardiac SurgeryChief of Cardiac Surgery, Department of VeteransAffairs Medical CenterM.D. Degree: Universidad de Buenos Aires, 1985Post-Graduate Training: Finochietto Hospital, BuenosAires, Argentina; St. Vincent Hospital & University ofMassachusetts Medical School, Worcester; Brigham & Women’sHospital, Boston; Harvard Medical School, Boston

Stephen K. Ball, M.D.Assistant Professor of Cardiac SurgeryMD Degree:Mississippi School of Medicine, 1987Post-Graduate Training: University of Mississippi MedicalCenter, Jackson; Rush University Medical Center, Chicago

PHYSICIANS AND STAFFOF CARDIAC SURGERY

David P. Bichell, M.D.Professor of Pediatric Cardiac SurgeryChief, Division of Pediatric Cardiac SurgeryM.D. Degree: Columbia University College of Physiciansand Surgeons, 1987Post-Graduate Training: Brigham & Women’s Hospital,Harvard Medical School, Boston; Children’s Hospital Boston,Harvard Medical School, Boston; Barnes-Jewish Hospital,Washington University, St. Louis; Columbia-Presbyterian Hospital,Columbia University, New York

Karla G. Christian, M.D.Associate Professor of Pediatric Cardiac SurgeryAssociate Chief, Pediatric Cardiac SurgeryM.D. Degree: University of Washington Medical Center, 1986Postgraduate Training: University of Washington MedicalCenter, Seattle; Vanderbilt University Medical Center, Nashville,

James P. Greelish, M.D.Assistant Professor of Cardiac SurgeryM.D. Degree:Wake Forest University School ofMedicine, 1992Post-Graduate Training: Hospital of the University ofPennsylvania, Philadelphia; Institute for Human Gene Therapy,University of Pennsylvania, Philadelphia; Brigham and Women’sHospital, Harvard Medical School, Boston

Steven J. Hoff, M.D.Assistant Professor of Cardiac SurgeryM.D. Degree: The Johns Hopkins University School ofMedicine, 1986Postgraduate Training: Vanderbilt University MedicalCenter, Nashville

Betty S. Kim, M.D.Assistant Professor of Cardiac SurgeryChief, Cardiac and Thoracic Surgery MauryRegional HospitalM.D. Degree: Yale University School of Medicine, 1991Postgraduate Training: Brooke Army Medical Center, SanAntonio; Walter Reed Army Medical Center, Washington, D.C.;Brigham and Women’s Hospital, Harvard Medical School, Boston

Michael R. Petracek, M.D.Professor of Clinical Cardiac SurgeryM.D. Degree: The Johns Hopkins School of Medicine, 1971Post-Graduate Training: Vanderbilt University Hospital,Nashville; Johns Hopkins Hospital, Baltimore

VANDERBILT HEART AND VALVEINSTITUTE ACCESS COORDINATORS

615-343-9188 or 866-VUMCHRTFax: 615-343-6559

Our guarantee:We will answer the phone within

two rings, 24 hours a day, 7 days a week.

Craig Climberg, PA-C

Edmund J. Donahue, PA-C

Nora Cobb, ANP-BC

Anna Fong, ACNP-BC

Rachel Forsythe, ACNP-BC

April Kapu, ACNP-BC

Stacy Kelley, ACNP-BC

Veronica Rowan, ANP-BC

PHYSICIAN ASSISTANTS

NURSE PRACTITIONERS

Megan Shifrin, ACNP-BC

Sean Smithey, ACNP-BC

Joshua Squiers, ACNP-BC

Kristie Walker, ACNP-BC

Brian Widmar, ACNP-BC

Thomas M. Stahl, PA-C

Bonnie Cook, RN Deborah Durrance, RN

Judy Ludwig, RN Brandon Massey, RN Patty Rush, RN

Jan Powers, RN Grace Vicente, RN

GENERAL CARDIOLOGY

Benjamin F. Byrd III, M.D.Professor of MedicineDirector, Adult Congenital Heart ProgramM.D. Degree: Vanderbilt University, 1977Post-Graduate Training: Vanderbilt University MedicalCenter, Nashville; Harvard University, Boston

Geoffrey Chidsey, M.D.Assistant Professor of MedicineMD Degree: Indiana University School of Medicine, 1994Post-Graduate Training:Medical University of SouthCarolina, Charleston; Vanderbilt University MedicalCenter, Nashville

Andre L. Churchwell, M.D.Assistant Professor of MedicineAssociate Dean, Diversity in Graduate MedicalEducation and Faculty AffairsM.D. Degree: Harvard University, 1979Post-Graduate Training: Emory University, Atlanta

Keith B. Churchwell, M.D.Assistant Professor of MedicineAssociate Medical Director, Vanderbilt Heart andVascular InstituteM.D. Degree:Washington University, 1987Post-Graduate Training: Emory University, Atlanta

Julie B. Damp, M.D.Assistant Professor of MedicineM.D. Degree: Vanderbilt University, 2001Post-Graduate Training: Vanderbilt University MedicalCenter, Nashville

Rob R. Hood, M.D.Assistant Professor of MedicineM.D. Degree: Tulane University, 1976Post-Graduate Training: Emory University AffiliatedHospitals, Atlanta

Waleed N. Irani, M.D.Assistant Professor of MedicineDirector, Outpatient Clinical OperationsM.D. Degree: University of North Carolina, 1990Post-Graduate Training: University of Texas SouthwesternMedical School, Dallas; Parkland Memorial Hospital, Dallas;Veterans Administration Medical Center, Dallas

Lisa A. Mendes, M.D.Assistant Professor of MedicineM.D. Degree: University of Connecticut Medical School, 1987Post-Graduate Training: Boston University MedicalCenter, Boston

David X. Zhao, M.D.Associate Professor of MedicineDirector, Cardiac Catheterization Laboratories andInterventional CardiologyM.D. Degree: Shanghai Medical University, 1985Post-Graduate Training: Vanderbilt University MedicalCenter, Nashville; Brigham and Women’s Hospital, Boston;Harvard Medical School, Boston

John H. Cleator, M.D., Ph.DAssistant Professor of MedicineM.D. Degree: Medical University of South Carolina, 1999Post-Graduate Training: Cleveland Clinic Foundation,Cleveland; Vanderbilt University Medical Center, Nashville

Marshall H. Crenshaw, M.D.Assistant Professor of MedicineM.D. Degree: Tulane University, 1982Post-Graduate Training: Emory University, Atlanta

Pete P. Fong, M.D.Assistant Professor of MedicineM.D. Degree: Vanderbilt University, 1998Post-Graduate Training: University of Washington MedicalCenter, Seattle; Vanderbilt University Medical Center, Nashville

Joseph L. Fredi, M.D.Assistant Professor of MedicineM.D. Degree: University of Tennessee, Memphis, 1983Post-Graduate Training: University of Rochester – StrongMemorial Hospital, Rochester; Vanderbilt University MedicalCenter, Nashville

Mark D. Glazer, M.D.Assistant Professor of MedicineM.D. Degree: University of Louisville, 1979Post-Graduate Training: Emory University, Atlanta

Henry S. Jennings III, M.D.Assistant Professor of MedicineMedical Director, Network DevelopmentM.D. Degree: Vanderbilt University, 1977Post-Graduate Training: Vanderbilt University MedicalCenter, Nashville

INTERVENTIONAL CARDIOLOGY

John A. McPherson, M.D.Assistant Professor of MedicineDirector, Cardiovascular Intensive Care UnitM.D. Degree: University of California-Los Angeles, 1993Post-Graduate Training: University of Virginia HealthSystems, Charlottesville; Johns Hopkins Hospital, Baltimore

Robert N. Piana, M.D.Associate Professor of MedicineM.D. Degree: University of Pennsylvania, 1987Post-Graduate Training:Massachusetts General Hospital,Boston; Beth Israel Hospital, Boston; Harvard MedicalSchool, Boston

Thomas R. Richardson, M.D.Assistant Professor of MedicineM.D. Degree: University of Virginia, 1995Post-Graduate Training: University of Alabama,Birmingham; University of Texas Health Science, San Antonio;Vanderbilt University Medical Center, Nashville

Mark A. Robbins, M.D.Assistant Professor of MedicineM.D. Degree:University of Mississippi School of Medicine, 1993Post-Graduate Training: Cleveland Clinic Foundation,Cleveland; University of Mississippi Medical Center, Jackson;Vanderbilt University Medical Center, Nashville

Joseph G. Salloum, M.D.Assistant Professor of MedicineM.D. Degree: American University of Beirut, Lebanon, 1996Post-Graduate Training: Cleveland Clinic Foundation,Cleveland; University of Texas, Houston; Vanderbilt UniversityMedical Center, Nashville

David A. Slosky, M.D.Assistant Professor of MedicineM.D. Degree: University of Colorado School ofMedicine, 1976Post-Graduate Training: Duke University Hospital,Chapel Hill

Debbie Drake-Davis, ACNP-BCCindy Giullian, ACNP-BCDeborah Haggard, ACNP-BCJason Jean, FNP-BCDebbie Martin, ACNP-BCMargaret Morrison, ACNP-BCHolly Pierce, ANP-BCCarol Scott, FNP-BC

NURSE PRACTITIONERS

CARDIAC ANESTHESIOLOGY

Robert J. Deegan, M.D., Ph.D.Associate Professor of AnesthesiologyDirector, Division of Cardiothoracic AnesthesiologyM.D. Degree: University College Dublin, Ireland, 1986Post-Graduate Training: Vanderbilt University MedicalCenter, Nashville

Brian S. Donahue, M.D., Ph.D.Associate Professor of AnesthesiologyDirector, Pediatric Cardiac AnesthesiaM.D. Degree: Emory University, 1992Post-Graduate Training: Mayo Graduate Schoolof Medicine, Rochester; Vanderbilt University MedicalCenter, Nashville

Susan S. Eagle, M.D.Assistant Professor of Clinical AnesthesiologyM.D. Degree: Medical College of Georgia, 1999Post-Graduate Training: Medical College of Georgia,Augusta; Vanderbilt University Medical Center, Nashville

Alexander K. Hughes, M.D.Assistant Professor of AnesthesiologyM.D. Degree: University of Vermont College of Medicine, 1997Post-Graduate Training: Maine Medical Center, Portland;Massachusetts General Hospital, Boston

Mias Pretorius, M.D.Assistant Professor of AnesthesiologyM.D. Degree: University of Pretoria, South Africa, 1993Post-Graduate Training: Vanderbilt University MedicalCenter, Nashville

Bernhard J. Riedel, M.D.Professor of AnesthesiologyM.D. Degree: University of the Free State, South Africa, 1987Post-Graduate Training: University of Cape Town, SouthAfrica; Royal Brompton and Harefield NHS Trust, London

Annemarie Thompson, M.D.Assistant Professor of Clinical AnesthesiologyM.D. Degree: Duke University, 1995Post-Graduate Training: University of California, SanFrancisco; Vanderbilt University Medical Center, Nashville

Chad E. Wagner, M.D.Assistant Professor of Clinical AnesthesiologyM.D. Degree: University of Texas-Houston, 1998Post-Graduate Training: Wake Forest University, Winston-Salem; Cleveland Clinic Foundation, Cleveland

Amr A. Waly, M.D.Assistant Professor of Clinical AnesthesiologyM.D. Degree: Ain-Shams University, Egypt, 1983Post-Graduate Training: Vanderbilt University MedicalCenter, Nashville; Emory University Hospitals, Atlanta

APPOINTMENTS AND SCHEDULING

FOR VALVE CLINIC

To make an outpatient appointmentfor consultation, simply call

615-343-9195Monday through Friday from 8 am until 5 pm, CST.

EMERGENCY CALLS

For urgent physician needsor for a patient transfer, please call:

866-886-2478or

615-343-9188

Fax: 615-343-6559to reach the access coordinator.

Our guarantee:We will answer the phone within two rings,

24 hours a day, 7 days a week.

The Vanderbilt Valve Surgery program is located inMedical Center East, South Tower. Parking is available in

the East Garage located in the same building.Valet parking available.

Remember to have your parking ticket stamped atthe registration desk for complimentary parking.

Red Coat VolunteersThe Vanderbilt Heart Red Coats are volunteers from the community who

welcome you as you arrive. They are stationed in Medical Center East at thesecond floor entrance. Many of our Red Coat volunteers have been patientshere themselves, or have had loved ones cared for at Vanderbilt. They arehappy to escort you and your family members to your clinic appointment.

VALVE SURGERY

1215 21st Avenue South

MCE, 5th floor, South Tower, Suite 5209

Nashville, Tennessee 37232-8802

VanderbiltHeart.com

Vanderbilt University is committed to principles ofequal opportunity and affirmative action.

Illustrations provided by Dominic Doyle.