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At the Heart of Progress
2016 CARDIAC SERVICES REPORT
NORTHERN DUTCHESS HOSPITAL
THE HEART CENTER
PUTNAM HOSPITAL CENTER

Cardiac and Vascular Clinical Leadership
From left, Andreas Spirig, MD, Medical Director of Vascular Service Line; Simon Gorwara, MD, President, The Heart Center;
Daniel O’Dea, MD, Executive Vice President of Cardiovascular Services; Mohan Sarabu, MD, Director of Cardiothoracic Surgery
2

DESTINATION HEART CARE,
IN THE HEART OF THE MID-HUDSON VALLEY
Welcome
On behalf of the physicians and staff of Cardiovascular
Services — part of the larger Health Quest
system — thank you for your interest in our 2016
Cardiac Services Report. We are proud to be at
the heart of progress in cardiac care, and a referral
destination of choice for cardiovascular patients in
the Mid-Hudson Valley.*
We uphold a steadfast and collective commitment to
cardiac excellence, and an unyielding dedication to
core goals of quality, safety, innovation and patient
satisfaction across the continuum of care. Our
cardiac surgery outcomes are among the best in New
York State. In fact, our talented interventional and
electrophysiology physicians strive to take the most
difficult cases and produce excellent outcomes. We are
privileged to work side-by-side with an outstanding
team of professionals, including specially trained
nurses, technical staff and allied health professionals,
all in support of a common goal: to help our patients
return home in better cardiac health.
We have also added progressive treatments such
as minimally invasive cardiac surgery and new
endovascular procedures for aortic, carotid and
peripheral vascular disease.
Our flagship hospital, Vassar Brothers Medical Center,
is undergoing a renaissance, with a modern patient
pavilion breaking ground in 2016. In addition, our
Division of Clinical Research provides patients access
to state-of-the-art technology and medicine through
clinical trials.
The three hospitals in our system — Vassar Brothers
Medical Center, Northern Dutchess Hospital and
Putnam Hospital Center — and our cardiology
group, The Heart Center,** comprise a true center of
excellence for cardiac care in the Mid-Hudson Valley.
Whether patient or provider, you can count on us to
provide care that represents the heart of progress —
today and tomorrow.
In order to improve quality, we routinely measure
performance and benchmark ourselves against the
top standards nationally, striving to move toward our
goal of top decile care. At the same time, the options
for treating cardiovascular disease continue to grow;
constant innovation is critical if we are to offer our
patients the most up-to-date care. We are the first
and only provider in the Mid-Hudson Valley to offer
Transcatheter Aortic Valve Replacement (TAVR), a
revolutionary treatment option for patients who are
not candidates for traditional open-heart surgery.
Daniel O’Dea, MD, FACC
Executive Vice President
of Cardiovascular Services
Robert Friedberg
President of Health Quest
Systems, Inc.
* Health Quest Systems, Inc. defines the Mid-Hudson Valley to include the counties of Dutchess, Orange, Putnam and Ulster.
**The Heart Center, a division of Hudson Valley Cardiovascular Practice, P.C.
3

EXCELLENCE DEFINED BY EXPERIENCE
Surgical Procedures
“We have a team who puts heart and soul into
everything it does. Together, we have many years
of experience and the best outcomes — one of
the lowest mortality rates in New York State for
the last nine years. It’s for that reason that other
local hospitals and physicians trust us with the
care of their cardiac patients.”
— MOHAN R. SARABU, MD
Vassar Brothers Medical Center has served the
Hudson Valley since 1887, and is the first and only
cardiothoracic surgery center between Westchester
County and Albany. Coronary bypass surgery, valve
surgery (including mitral valve repairs and transcatheter
aortic valve replacement [TAVR]), coronary artery
bypass grafting (CABG), aortic aneurysm surgery
and reoperative surgery are routinely performed at
Vassar Brothers Medical Center.
Our demonstrable success in complex procedures
is attributable to the more than 75 years of combined
experience of our cardiothoracic surgeons and a
dedicated team of cardiac professionals, including
renowned cardiologists, specialty-trained nurses,
nurse practitioners, physician assistants and anesthesiologists.
Our facilities are equally exceptional,
with state-of-the-art operating suites for cardiac
surgery, a dedicated CT ICU and an emergency
department with access to specialty-trained cardiac
professionals, monitored beds and 24-hour urgent
care for cardiac patients. We also offer dedicated
cardiac units for surgical and nonsurgical patients,
a post-cardiac ICU and a coronary ICU.
Leader in Valve Surgery
Whenever possible, Vassar Brothers Medical Center’s
cardiac program focuses on mitral valve repair over
replacement. As a regional leader in repair, we often
find this the best option for patients with a regurgitant
mitral valve (leakage of blood backward through the
mitral valve). Our success rate has been exceptional,
with 100% survival for aortic and mitral procedures
in 2014 through 2015. Additionally, there have been
no reoperations for mitral valve procedures during
this time period.*
* Sources: Society of Thoracic Surgeons National Adult Cardiac
Surgery Database 2015 through June.
New York State non-published data 2015, July through December.
Vassar Brothers Medical Center has
100% Survival Rate for Valve Procedures
Survival Rates
100.0%
98.0%
96.0%
94.0%
92.0%
90.0%
88.0%
86.0%
AVR
AV
REPLACE
& CAB
MV
REPAIR
MV
REPAIR
& CAB
MVR
VASSAR BROTHERS MEDICAL CENTER
STS BENCHMARK COMPARISON
MV
REPLACE
& CAB
Source: Society of Thoracic Surgeons National Adult Cardiac
Surgery Database 2015 Harvest 3 Site Report Images
With patient outcomes that far surpass the
national average, Vassar Brothers Medical Center
sees a growing number of transfers from
other local hospitals and physicians. In 2014,
Vassar Brothers Medical Center had 503 referrals,
and in 2015, 547 referrals — a 9 percent increase.
Source: Internal VBMC Data
4

From left, cardiothoracic surgeons Peter Zakow, MD; Mohan Sarabu, MD; Rohit Shahani, MD
Surgeons perform a valve replacement
5

EXCELLENCE IN CORONARY ARTERY
BYPASS GRAFTING (CABG)
Mortality and Readmission Rates Below New York State Averages
In-Hospital/30-Day Risk-Adjusted Mortality for
Isolated CABG Surgery in New York State, 2012
In-Hospital/30-Day Risk-Adjusted Readmission Rates
for Isolated CABG Surgery in New York State, 2012
NEW YORK STATE AVERAGE 1.46
NYP — COLUMBIA
PRESBYTERIAN 1.9
NEW YORK STATE AVERAGE 14.39
NYP — WEILL CORNELL 15.93
ALBANY MEDICAL
CENTER 1.69
NYP — COLUMBIA
PRESBYTERIAN 13.44
WESTCHESTER MEDICAL
CENTER 1.46
WESTCHESTER MEDICAL
CENTER 12.72
NYP — WEILL CORNELL 1.39
ST. PETER’S HOSPITAL
(ALBANY) 10.58
ST. PETER’S HOSPITAL
(ALBANY) 0.69
VASSAR BROTHERS
MEDICAL CENTER 8.64
VASSAR BROTHERS
MEDICAL CENTER 0.5
ALBANY MEDICAL
CENTER 8.04
0.0 0.5 1.0 1.5 2.0 0 2 4 6 8 10 12 14 16
Source: NYS DOH Adult Cardiac Surgery Report, 2010-2012, Published October 2015
2015 TOTAL
345
OPEN HEART PROCEDURES
Source: 2015 VBMC Internal Data
6

EXCELLENCE IN CORONARY ARTERY
BYPASS GRAFTING (CABG)
Complication Rates Continually Below New York State and National Averages
FOR THE PAST
9 years
SURGICAL SITE INFECTIONS HAVE
CONSISTENTLY BEEN LOWER
THAN THE STATE AVERAGE
Source: NHSN Data Through October 2015
Deep Sternal Wound Infection (Observed Rate)
0% 0% 0% 0.3%
0.30%
0.25%
0.20%
0.15%
0.10%
0.05%
0.00%
2013 2014 2015 2015 2015
VASSAR BROTHERS
MEDICAL CENTER
STS
BENCHMARK
COMPARISON
Any Complication
Any Reoperation
40%
35%
30%
25%
20%
15%
10%
5%
0%
24.7% 22.1% 19.0% 37.3% 1.2% 1.3% 1.3% 3.5%
3.5%
3.0%
2.5%
2.0%
1.5%
1.0%
0.5%
0.0%
2013 2014 2015 2015
2013 2014 2015 2015
VASSAR BROTHERS
MEDICAL CENTER
STS
BENCHMARK
COMPARISON
VASSAR BROTHERS
MEDICAL CENTER
STS
BENCHMARK
COMPARISON
Source: Society of Thoracic Surgeons National Adult Cardiac Surgery Database 2015 Harvest 3 Site Report Images
7

Pictured above (middle), M. Zubair Jafar, MD, Medical Director of the Cardiac Catheterization Lab and Structural Heart Program
8

NEW FRONTIER IN VALVE CARE
Transcatheter Aortic Valve Replacement
“Many people see a patient who is 80 years or
older and think, ‘They’re too old for this.’ The key
is, nobody is too old. The TAVR procedure gives
us the ability to improve the quality of someone’s
life, irrespective of age.”
— M. ZUBAIR JAFAR, MD
Vassar Brothers Medical Center is the first and
only provider in the Mid-Hudson Valley to offer
Transcatheter Aortic Valve Replacement (TAVR),
a cutting-edge procedure for patients with severe
aortic stenosis (narrowing of a valve) who, due to
age or disease, are not candidates for open-heart
surgical aortic valve replacement.
Patients under consideration for TAVR undergo rigorous
evaluation at the Valve Clinic, including echocardiography
and functional capacity tests. The evaluation process
concludes with a multidisciplinary valve conference, in
which all of the clinicians involved in the patient’s care
discuss the patient at length and come to a consensus
on the optimal treatment approach.
Many of the patients who undergo TAVR are 80 years
or older who may otherwise be healthy but cannot
tolerate open-heart surgery. With TAVR, they are able
to live a much more active lifestyle. Vassar Brothers
Medical Center is committed to innovation in valve care
and to improving the quality of life for cardiac patients
at any age.
Similar to a stent placed in an artery, the TAVR
approach delivers a fully collapsible replacement
valve to the site through a catheter. Most of these
procedures are performed transfemorally through a
small puncture in the leg. One of the advantages of
TAVR is that clinicians can access the diseased aortic
valve using several different avenues as dictated by the
patient’s anatomy. This approach is minimally invasive,
enabling the surgeon to replace the valve without
opening the chest, resulting in a more rapid recovery
than a traditional, open-heart valve replacement.
Implantation of an Edwards SAPIEN 3
transcatheter aortic valve via transfemoral approach
Image courtesy of Edwards Lifesciences LLC, Irvine, CA.
Vassar Brothers Medical Center is the first and only provider in the Mid-Hudson Valley
to offer Transcatheter Aortic Valve Replacement (TAVR).
9

WHEN EVERY MINUTE COUNTS
Percutaneous Coronary Intervention
“The only way a program like this can be
successful is when you have a whole team
working together — the ED nurses, the ED doctors,
the cath lab nurses, the cath lab doctors, the EMS
professionals. Everyone here is highly skilled,
highly trained and dedicated to getting the
best possible outcomes.”
— SIMON GORWARA, MD
predominantly radial-first approach, Vassar Brothers
Medical Center has seen a considerable drop in the
rate of access site bleeding. Due to the volume
of radial artery procedures performed by our team
of interventional cardiologists, every patient benefits
from an exceedingly high level of experience.
VBMC RADIAL ARTERY ACCESS VS. FEMORAL
Since 2000, Vassar Brothers Medical Center has
seen great success with Percutaneous Coronary
Intervention (PCI), a non-surgical procedure to
restore blood flow to a stenotic (narrowed) area
within an affected coronary artery. We credit our
success to well-qualified, experienced and talented
interventional cardiologists who perform a large
volume of procedures, as well as rigorous quality
control in the catheterization lab.
We are at the heart of progress with new techniques
and innovative procedures that lead to fewer
readmissions, shorter recovery times and rapid
door-to-balloon responses — the response time
from a patient’s arrival at the hospital to when
the blocked artery is cleared in the cardiac
catheterization laboratory.
Vassar Brothers Medical Center addresses a large
number of PCI cases with a radial artery approach
(through the wrist). Radial artery access, an innovative
cardiac catheterization technique, improves the
patient’s experience by facilitating a quicker recovery
and reduced complication rates. After switching to a
RADIAL — 68% FEMORAL — 32%
0 25 50 75 100
Source: 2015 Internal VBMC Data
The patient’s outcome is always top-of-mind at Vassar
Brothers Medical Center. We continually gather data in
order to identify areas for improvement in both quality
of care and timely intervention in patients having heart
attacks. We utilize mobile technology to wirelessly
send 12-lead EKG data from the ambulance to the
ED while the patient is en route. We also monitor our
treatment and keep an eye on patient data, including
tracking the time between patient arrival in the ED and
administration of an EKG, tracking the time between
arrival in the ED and arrival at the catheterization lab,
and tracking the time required for the team to get the
artery open. In this way, we are able to keep our doorto-balloon
time significantly below the American Heart
Association benchmark.
10

Pictured above (bottom), Simon Gorwara, MD
OUR AVERAGE
DOOR-TO-BALLOON TIME IS
59.9
minutes
33% BELOW THE AMERICAN
HEART ASSOCIATION STANDARD
90-MINUTE BENCHMARK*
*Source: ACC/AHA Circulation. January 14, 2014; 129(2): 194-202
11

BY CONTINUALLY MONITORING PATIENT DATA, WE CAN PROVIDE BETTER-QUALITY
CARE AND MORE TIMELY INTERVENTION IN PATIENTS HAVING HEART ATTACKS
Excellence In Percutaneous Coronary Intervention
30-Day Observed Mortality
Emergency PCI 2010-2012 Discharges
PCI In-Hospital Risk
Adjusted Mortality
3.0
10TH PERCENTILE
90 TH PERCENTILE
2.5
2.0
3.17 2.47 1.83 1.68 1.37 1.01
1.5
1.0
0.5
2.30
2.77
VASSAR BROTHERS
MEDICAL CENTER
0.0
VASSAR BROTHERS
MEDICAL CENTER
NEW YORK
STATEWIDE TOTAL
PCI In-Hospital Risk
Adjusted Rate of Bleeding Events
10TH PERCENTILE
90 TH PERCENTILE
30-Day Observed Mortality
Non-Emergency PCI 2010-2012 Discharges
7.10 5.49 4.15 2.85 2.81 1.39
VASSAR BROTHERS
MEDICAL CENTER
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0.0
0.68
0.59
Proportion of STEMI Patients Receiving
Immediate PCI Within 90 Minutes
10TH PERCENTILE
90 TH PERCENTILE
VASSAR BROTHERS
MEDICAL CENTER
NEW YORK
STATEWIDE TOTAL
83.45 89.49 94.59 98.16 99.07 100
VASSAR BROTHERS
MEDICAL CENTER
Source: NYS DOH PCI Report 2010-2012 for Emergency
and Non-Emergent
Source: NCDR Institutional Outcomes Report 2015Q3
12

Performance Above National Averages for Acute Myocardial Infarction Outcomes
Acute Myocardial Infarction
Mortality Rate
VASSAR BROTHERS MEDICAL CENTER 14.0%
PUTNAM HOSPITAL CENTER 12.5%
NORTHERN DUTCHESS HOSPITAL 12.4%
0 3 6 9 12 14.1 15
NATIONAL DEATH RATE FOR HEART ATTACK PATIENTS 14.1%
Source: Hospital Compare, Retrieved May 23, 2016, www.medicare.gov/hospital compare/search
Applicable Data Dates: July 2012 through June 2015; Date ranges for mortality and readmissions are July 2012 through June 2015
Acute Myocardial Infarction Readmission Rate:
Exceeding the National Average of 10.18% in all Three of our Facilities
2015 8.64%
2014 9.39%
2013 8.10%
0 2 4 6 8 10 10.18 12
NATIONAL AVERAGE 10.18%
Source: Crimson, 2015 January through November
13

James Lyons, MD, Board-Certified Heart Failure Specialist, Director of Heart Failure Program
Annual Survivorship Rates
for Congestive Heart Failure
100%
90%
Source: Crimson, 2015 January through December
80%
2013 2014 2015
94.50% 94.37% 96.27%
14

CUTTING-EDGE CARE FOR HEART FAILURE,
CLOSER TO HOME
Heart Failure
“The goal of the Heart Success Team at Vassar
Brothers Medical Center is to help patients
manage their heart condition and improve
their quality of life. During the last five years,
thanks to advancements like CardioMEMS,
we are achieving this goal.”
— JAMES LYONS, MD
Vassar Brothers Medical Center brings innovative
technology home to Mid-Hudson Valley residents. Over
the last five years, we have built a program rich with
advanced technology to help patients with heart failure
remain at home and enjoy a better quality of life. Today,
our state-of-the-art heart failure program features the
CardioMEMS HF System and peripheral ultrafiltration.
CardioMEMS HF System —
heart monitoring from the comfort of your home
A wireless monitoring sensor, CardioMEMS is
used to help manage patients with chronic heart
failure. The CardioMEMS sensor is implanted in the
pulmonary artery during a non-surgical procedure
to directly measure pulmonary artery pressure. The
system transmits daily sensor readings to our team,
allowing us to proactively and remotely manage patient
treatment to reduce the likelihood of hospitalization.
Peripheral Ultrafiltration —
reducing hospital stays and readmission
Peripheral ultrafiltration is emerging as a viable, and in
some cases preferred, option for sodium and fluid removal.
The procedure allows for the removal of a larger volume of
fluid in a shorter period of time. Based on the results of the
UNLOAD* trial, peripheral ultrafiltration shortens hospital
stays, allows the patient to go home on a lower diuretic
dose, and potentially reduces the likelihood of being
readmitted. Volume removal was not associated with
disruption of electrolyte balance, worsening of renal
distress or impact on blood pressure or heart rate of
clinical significance. On average, our patients lose 26.1
pounds of water during their hospital stay.
Source: 2015 Internal VBMC Data
CardioMEMS sensor
size of a dime
(shown at actual size)
*Ultrafiltration Versus Intravenous (IV) Diuretics for Patients Hospitalized
for Acute Decompensated Heart Failure: UNLOAD, CHF Solutions, 2005.
15

ADVANCED HEART CARE FOR CANCER PATIENTS
Cardio-Oncology
“This is an early and exciting field. As cancer
survivorship continues to improve, we will see
more, rare cardiac side effects that previously
never had the chance to manifest. Vassar
Brothers Medical Center is the only center in
the Mid-Hudson Valley providing both the
imaging and clinical expertise to provide care
for these patients.”
— KAMRAN HALEEM, MD
Vassar Brothers Medical Center offers a multidisciplinary
approach to cancer care, emphasizing
an individual approach to each patient. The physicians
of the Dyson Center for Cancer Care include medical
and surgical oncologists, radiation oncologists and
specially trained cardiologists.
Vassar opened the Mid-Hudson Valley’s first and only
cardio-oncology clinic in 2013. The program cares for
two types of patients with cancer: those undergoing
chemotherapy with a pre-existing heart problem, and
those without heart problems whose cancer therapy
includes medications or radiation treatments that
may affect the heart.
The evaluation begins with a detailed history,
including all prior therapies, and a thorough physical
exam. Cardiac function is assessed utilizing 3-D
echocardiography; in some cases, further testing
may be necessary. Working with the oncology team,
the treatment plan for potential cardiac side effects
is assessed. Blood tests may be necessary after
treatments such as chemotherapy to further refine the
risk profile. Then, the multidisciplinary team devises a
treatment plan to minimize the likelihood of any further
damage. The Heart Center operates one of the few
imaging labs in the region with the know-how to follow
subtle changes in cardiac function that may occur early
in cancer therapy.
Our team approach allows us to intervene with the
clinical capability necessary for optimal care of these
complex patients. There are few programs in the
Mid-Hudson Valley with the level of expertise afforded
by Vassar Brothers Medical Center, and none with our
experience, to follow patients so closely in all aspects
of their care.
With improvements in cancer care and survival,
long-term side effects of therapy are more common.
At Vassar, the cardiologists work closely as a team
with a patient’s medical oncologist, radiation
oncologist and surgeon to plan an individualized
treatment plan that maximizes success while
minimizing complications.
16

From left, Kamran Haleem, MD, Medical Director of Cardio-Oncology; Radhika Rachamalla, MD;
James Leonardo, MD, Director of Medical Oncology
17

THE PULSE DRIVING HEALTHIER HEARTS
Electrophysiology Procedures/Catheter Ablations
“I’m very proud and excited to say that Vassar
Brothers Medical Center offers state-of-the-art
technology such as the S-ICD, an implantable
defibrillator that does not require intravenous
lead placement, which may be preferable for
younger patients.”
— SANKAR VARANASI, MD
Cardiac electrophysiology procedures are used
to diagnose and treat cardiac arrhythmias (irregular
heartbeats) and other cardiac diseases. The cardiac
electrophysiology team at Vassar Brothers Medical
Center consists of three fellowship-trained physicians,
two nurse practitioners and two technologists. They
provide a comprehensive arrhythmia service, including
a “device clinic” where patients, once they receive a
pacemaker or a defibrillator, receive their follow-up
care. The team works in conjunction with the primary
cardiologist to ensure constant communication.
Our most valuable diagnostic tool is an electrophysiology
(EP) study, which records the electrical
activity and electrical pathways of the heart. During
the EP study, we may also map the spread of
electrical impulses during each beat in order to
locate the source of an arrhythmia. An EP study
helps identify patients who — while they may not
have any apparent signs — may be at risk of having
a future cardiac event or sudden cardiac death.
offers a full cure, and therefore eliminates the need
for medications, thus improving the patient’s quality
of life.
Vassar Brothers Medical Center is among the first
hospitals in the Mid-Hudson Valley to employ the
EMBLEM TM S-ICD System, an implantable defibrillator
placed under the skin in the chest. We’re also
among the first in magnetic navigation technology.
Conventional catheters are usually manipulated
by physicians standing at the bedside and can be
associated with a higher incidence of complications.
The magnetic navigation system makes catheter
placement very precise, to the millimeter, and
minimizes certain risks.
CAPABILITIES AND TECHNOLOGIES
Cardiac resynchronization therapy (CRT)
EP study for diagnosis and planning treatment
EMBLEM TM S-ICD system (defibrillator implant)
Catheter ablation with robotic
magnetic navigation
EPOCH robotic navigation technology
and 3D imaging
Laser lead extraction
In cases of a known cardiac arrhythmia, an EP study
can help determine the cause of the heart rhythm
disturbance and the best course of treatment,
such as implanting a defibrillator or pacemaker,
or prescribing medications or catheter ablation.
In a significant number of arrhythmias, ablation
18

Sankar Varanasi, MD, Director of Clinical Cardiac Electrophysiology; Sarah Levin, MD
19

From left, Britt Tonnessen, MD; Simon Gorwara, MD; Andreas Spirig, MD; Mark Kulbaski, MD; Michael Yen, MD
VASCULAR PROCEDURES:
Blunt Thoracic Aortic Injury (BTAI)
Thoracic endovascular repair
Endovascular aneurysm repair
Peripheral bypass surgery
Endovascular abdominal aortic repair (EVAR)
Renal access procedures
Percutaneous peripheral intervention
Carotid endarterectomy
©2016 Medtronic. All Rights Reserved.
Stent Graft
Inside Aorta
20

OPENING NEW POSSIBILITIES IN HEART HEALTH
Vascular Services
“What we do really requires an interdisciplinary
approach. At Vassar Brothers Medical Center,
that involves cardiologists, interventional
cardiologists, cardiac surgeons and other
subspecialties that make care so much better
for our patients.”
— ANDREAS SPIRIG, MD*
Vassar Brothers Medical Center sets the bar
high for vascular surgery and high-end, complex
vascular interventions in the Mid-Hudson Valley.
In addition to angiography, endovascular procedures,
angioplasty and stenting, we have the added
capability of performing state-of-the-art procedures
such as thoracic aneurysm repair and abdominal
aortic aneurysm repair.
Vassar Brothers Medical Center is also at the
forefront of technology to decrease the amputation
rate and save limbs. Employing a team approach,
we work very closely with podiatric surgeons,
infectious disease specialists and endovascular
surgeons to help patients with limb-threatening
diseases avoid amputation.
Our team repairs complex aortic pathologies, which
include complex aneurysms and aortic dissections.
We treat these conditions at Vassar Brothers Medical
Center under the umbrella of our cardiovascular unit.
We are also at the leading edge of employing
atherectomy devices, which remove plaques of fatty
material from blood vessels within the body.
Vassar Brothers Medical Center also uses
drug-eluting balloon technology, a significant
breakthrough in the standard of care for treating
peripheral artery disease in the leg. For venovenous
occlusive disease — deep vein thrombosis — we
use pharmacomechanical thrombectomy and
thrombolysis, the technology of using medication
to dissolve the clot.
We are committed to opening up new possibilities
in heart health by employing procedures unique
to the region and, in many cases, demonstrating
capabilities that surpass national medical facilities.
We strive to stay at the heart of progress by providing
forward-thinking care close to where our patients live.
* The physician identified is neither an agent nor an employee of Health Quest or any of its affiliate organizations.
This physician has selected our facilities as the place where he wants to treat and care for his private patients.
21

NONINVASIVE DIAGNOSTICS
Cardiac Imaging
The three hospitals in our system — Vassar Brothers
Medical Center, Northern Dutchess Hospital and
Putnam Hospital Center — and our cardiology group,
The Heart Center, offer the most advanced imaging
technology in the region. Patients have access to
sophisticated noninvasive diagnostic services, such as
implantable loop recorders for longer-term monitoring,
when routine Holter monitoring is inconclusive. Each
service is designed to identify potential heart issues
before a serious cardiac event occurs. With early
detection, cardiologists work with their patients to
develop a personalized treatment plan.
Holter Monitor
FROM THE HEART | MARION LEVINE
Exhaustion was a regular part of Marion’s day. Working
full time and parenting her 10-year-old son, she frequently
had to rest between routine tasks, and even walking down
her driveway to get the mail was a struggle. A 24-hour
Holter monitor was used to record Marion’s EKG, in
addition to TEE testing, which uses a scope to produce
pictures of the heart. The noninvasive testing indicated
mitral valve dysfunction. “After my valve was repaired,
amazingly, I was able to go home after 72 hours.* Now
I’ve got my life back — gardening, bicycle riding and
working out at the gym.”
* Patient recovery time can differ. Average discharge is 3-5 days.
22

DIAGNOSTIC SERVICES
AVAILABLE SERVICES
NORTHERN
DUTCHESS
HOSPITAL
PUTNAM
HOSPITAL
CENTER
VASSAR
BROTHERS
MEDICAL
CENTER
THE HEART
CENTER
Abdominal Aortic Ultrasound
Abdominal Aortic
Aneurysm Screening
Aortoiliac Artery Duplex
Automatic Implantable
Cardioverter Defibrillator
Interrogation
Bubble Study and Definity®
Contrast Echocardiograms
Carotid Ultrasound
Echocardiography
Electrocardiography
Event Recorders
Holter Monitoring and Scanning
Nuclear, Pharmacological and
Routine Stress Testing
Pacemaker Interrogation
Peripheral Arterial Duplex
Peripheral Venous Duplex
PVR Studies With ABI,
Segmentals and Exercise
Renal Artery Duplex
Stress Echocardiography
Transesophageal
Echocardiography
Transtelephonic Arrhythmia
Detection
23

COORDINATED REHABILITATION
FOR BETTER OUTCOMES
Cardiac Rehab
Vassar Brothers Medical Center, Northern Dutchess
Hospital, Putnam Hospital Center and The Heart
Center bring together experts focused on helping
patients reach their optimal level of fitness through a
coordinated outpatient cardiac rehabilitation program.
Trained healthcare professionals work jointly to
improve overall health through a combination
of rehabilitation, prevention and education. The
team includes the patient’s primary care physician,
cardiologist, registered nurses, exercise physiologist,
exercise leaders and a registered dietitian.
As education is key to better outcomes, we also
encourage cardiac rehab participants to attend a
one-hour class, three times a week. These classes
cover exercise guidelines, stress management and
nutrition. This enables patients to continue on
a healthy path post-rehab, with access to our
medically-based fitness center.
CARDIAC REHAB PROGRAM
Medically supervised exercise
with a cardiologist on site
EKG monitoring while exercising
Risk factor analysis and management
Dietary guidance
BENEFITS OF CARDIAC REHAB
A 20-30% reduction in all-cause
mortality rates
Decreased mortality at up to five years
post-participation
Reduced symptoms
(angina, dyspnea, fatigue)
Reduction in nonfatal recurrent myocardial
infarction over median follow-up of 12 months
Source: American Heart Association
CARDIAC REHAB CAN LEAD TO
20-30%
REDUCTION IN ALL-CAUSE MORTALITY
Source: American Heart Association
24

Above, Catherine Ahern, RN, Putnam Hospital Center Cardiac Rehabilitation Coordinator, consults with cardiac patient Elizabeth Cianflone
FROM THE HEART | Dave Binger
Since receiving a heart transplant in August 2013,
Dave has been attending cardiac rehab for more
than two and a half years. “My exercise regimen
was set up by the exercise physiologist and
initially monitored constantly by the nursing staff.
It’s the reason I can now exercise comfortably
and confidently.”
25

TURNING HEART CARE EXPERTISE INTO
HEART DISEASE PREVENTION
Preventive Cardiology
Vassar Brothers Medical Center helps to empower our
patients and the community at large with programs
designed to educate and prevent heart disease.
Women’s Heart Sense Program
According to the American Heart Association, heart
disease is the number one killer of women, causing one
out of three deaths each year. That’s approximately
one woman every minute. The Women’s Cardiac Care
Program at The Heart Center is at the vanguard of
the changing world of heart health for women. We
employ the latest clinical research, imaging techniques
and minimally invasive procedures for comprehensive
management of heart and vascular disease with
a particular focus on the needs of women.
Heart Failure Program
Through the “Heart Success” program, we help
participants manage their heart conditions, reduce
other health complications and improve their quality
of life. Our multidisciplinary team of caregivers
includes specialists in cardiology, nursing, pharmacy,
nutrition, case management, physical therapy and
home care. Together, they create a customized
treatment plan for heart failure patients.
Community Education
We strongly believe that we can all be caregivers
in an emergency situation. Each year our system trains,
on average, nearly 8,000 community members and
health-care providers in lifesaving techniques such as
Cardiopulmonary Resuscitation (CPR) and Automated
External Defibrillator (AED) use.
We are one of the largest American Heart Association
training centers in the Northeast, training nearly
8,000 people a year in lifesaving techniques.
26

Benjamin Schaefer, MD; Douglas Kroll, MD
3D Echocardiogram
27

THOUGHT LEADERSHIP
INFORMED BY EXPERIENCE
Abstracts, Publications and Clinical Research
Sharing Knowledge to Advance Practices and Outcomes
Vassar Brothers Medical Center’s commitment to
education is inherent at every level of our organization.
Our physicians regularly share their findings with peers
through abstracts, scholarly papers and clinical research.
SELECTED PUBLICATIONS
Bhatt, D. L., Lincoff, A. M., Gibson, C.
M., Stone, G. W., McNulty, S., Montalescot,
G., Kleiman, N. S., Goodman, S. G.,
White, H. D., Mahaffey, K. W., Pollack
Jr., C. V., Manoukian, S. V., Widimsky, P.,
Chew, D. P., Cura, F., Manukov, I., Tousek,
F., Jafar, M. Z., Arneja, J., Skerjanec, S.
& Harrington, R. A. for the CHAMPION
PLATFORM Investigators. (2009).
Intravenous platelet blockade with
cangrelor during PCI. New England
Journal of Medicine, 361(24), 2330-41.
Halstead, J. C., Meier, M., Spielvogel,
D., Bodian, C., Wurm, M., Shahani, R. &
Griepp, R. B. The fate of the distal aorta
after repair of acute Type A dissection.
(2007). Journal of Thoracic & Cardiovascular
Surgery, 133(1), 127-35.
Kiernan, M. S., Joseph, S. M., Katz, J.
N., Kilic, A., Rich, J. D., Tallman, M. P.,
Van Buren, P., Lyons, J. J., Bethea, B.,
Eckman, P., Gosev, I., Lee, S. S.,
Soleimani, B., Takayama, H., Patel,
C. B. & Uriel, N. (2015). Sharing the
care of mechanical circulatory support:
Collaborative efforts of patients/
caregivers, shared care sites, and left
ventricular assist device implanting
centers. Circulation: Heart Failure, 8(3),
629-635.
Mody, K. P., Lyons, J. J., Jorde, U. P. &
Uriel, N. (2015). A cold taken to heart.
Circulation, 131(19), 1703-1711.
O’Dea, D., Sanganalmath, S. K., Schnee,
J., Whetteckey, J., Ting, N. & Duffy, C.
(2015, July). Management of gastrointestinal
symptoms in patients treated
with Dabigatran Etexilate. Poster
presented at the 20th World Congress
on Heart Disease, Vancouver, BC.
Shahani, R. & Chin, C. (2010). Anatomy
of the Thorax. In F. Sellke, S. Swanson
& P. J. del Nido (Eds.), Surgery of the
Chest (8th ed.) (pp. 3-24). Philadelphia,
PA: Saunders.
Stone, G. W., Bertrand, M. E., Moses, J.
W., Ohman, E. M., Lincoff, A. M., Ware, J.
H., Pocock, S. J., McLaurin, B. T., Cox, D.
A., Jafar, M. Z., Chandna, H., Hartmann,
F., Leisch, F., Strasser, R. H., Desaga, M.,
Stuckey, T. D., Zelman, R. B., Lieber, I.
H., Cohen, D. J., Mehran, R. & White, H.
D. for ACUITY Investigators. (2007).
Routine upstream initiation vs. deferred
selective use of glycoprotein IIb/IIIa
inhibitors in acute coronary syndromes:
The ACUITY timing trial. The Journal
of the American Medical Association,
297(6), 591-602.
SELECTED ABSTRACTS
Jafar, M. Z., Bhatti, N., Moin, D.,
Pedevillano, L., Munnangi, L., Siddiqui,
A., O’Dea, D., Schek, L., Yen, M., Ling, J.
& Solomon, L. (2010, March). Assessment
of plaque burden using coronary
CT calcium scores in police officers and
firefighters in New York State. Poster
presented at the American College
of Cardiology 59th Annual Scientific
Session, Atlanta, GA.
Jafar, M. Z., Moin, D., Lichtenberg, S.,
Weinrich, D., Jha, S., Mulcahey, S.,
Mercado, N., McDowell, E. & Gerber, G.
(2008, March). Multidisciplinary lipid
clinic model results in improved
cardiovascular outcomes. Poster
presented at the American College
of Cardiology 57th Annual Scientific
Session, Chicago, IL.
Jafar, M. Z., Rab, Z., Pedevillano, L.,
Moin, D., Weinreich, D., Siddiqui, A.
& O’Dea, D. (2009, March). Multidisciplinary
discharge protocol reduces
long-term outcomes in acute coronary
syndromes. Poster presented at the
American College of Cardiology 58th
Annual Scientific Session, Orlando, FL.
Varanasi, S., Jafar, M. Z., Gillen, E.,
Crump, K., Muneer, H., Ubaid, H., Samra,
S. & Gottipaty, V. (2014). Appropriate
therapies in device recipients with
improved left ventricular function
[Abstract]. Journal of the American
College of Cardiology, 63(12_S).
28

Top, from left: Trisha Burrello, Tricia Landi, Louis Kantaros, MD, Camille Finkle, Teresa Hoey, Susan Lake
Above, from left: William Rausch, Daniel Lackaye, Trisha Burrello, Ian Portelli, PhD, Nadia Elkarra, Maria Akhondzadeh, Cindy Miller, Carissa Sharp
We strive to improve the health of our community by
setting standards of excellence in research, education,
clinical services and quality of care. Clinical research
gives patients an opportunity to proactively participate
in disease prevention, diagnosis and treatment.
Through the Division of Clinical Research, we provide
a local site for national and international clinical trials,
allowing us to deliver on our promise of quality services
and excellence of care to the Mid-Hudson Valley. Our
system’s diverse and inclusive research endeavors also
provide healthcare professionals with the ability to
advance their medical and surgical practices.
If you are a patient, researcher or sponsor interested
in our clinical trials, we will be more than happy to
speak with you and answer any questions you may
have. Please contact Ian Portelli, PhD, Division of
Clinical Research, Vassar Brothers Medical Center,
28 Reade Place, 1st Floor, Poughkeepsie, NY 12601.
P: (845) 483-6825 • F: (845) 483-6503
research@health-quest.org
TTY/Accessibility: (800) 421-1220
CURRENT TRIALS
THEMIS — Comparing the effect
of long-term treatment with
ticagrelor twice daily vs. placebo
for the prevention of major
cardiovascular (CV) events.
AdaptResponse — Whether
AdaptivCRT® (aCRT) algorithm
has a superior outcome
compared to standard CRT
devices in CRT-indicated patients
with normal atrio-ventricular
(AV) conduction and left bundle
branch block (LBBB).
CardioMEMS HF — Evaluate
the use of the FDA-approved
CardioMEMS HF System in
patients with Class III heart failure.
ARTEMIS — Assess the impact
of copayment reduction by
equalizing the copayment of
clopidogrel and ticagrelor on
patient adherence to therapy.
SPIRE 1 & SPIRE 2 — The
Evaluation of Bococizumab
(PF-04950615;RN316) in Reducing
the Occurrence of Major Cardiovascular
Events in High-Risk
Subjects.
IN FOLLOW-UP
Camelia TIMI 61
DECLARE TIMI 58
RAID
REVEAL
Odyssey LTS13463
(OLE)
Odyssey Alternative
EUCLID
ACCELERATE
Odyssey Outcomes
29

RECOGNIZED FOR A HIGHER
STANDARD OF CARE
Recognition and Accredited Facilities
National Research Corporation’s
Consumer Choice Awards (2015)
Vassar Brothers Medical Center was chosen
by consumers as their hospital of choice for
the 11th consecutive year.
Get with the Guidelines® Gold Plus Achievement
for Heart Failure (2014)
Vassar Brothers Medical Center has been recognized
by the American Heart Association for consistent
performance of key quality measures for 24 or more
consecutive months.
Top Performer on Key Quality Measures (2015)
The Joint Commission recognized Vassar Brothers
Medical Center as a top performer on key quality
measures for heart attack, heart failure, pneumonia
and surgical care.
HEART CENTER RECOGNITION
Center of Excellence, endorsed by the
American College of Cardiology (2015)
NCQA Recognized Practice (2012)
IAC Accredited Facility Echocardiography (2015)
IAC Accredited Facility Vascular Testing (2013)
IAC Accredited Facility Nuclear Cardiology (2013)
IAC Accredited Facility CT (2014)
American College of Cardiology’s Platinum Practice
Center of Excellence Award for first quarter 2015 for
patients with atrial fibrillation. The award is based on
the Pinnacle Registry of the National Cardiovascular
Data Registry.
FROM THE HEART | Edward Covert
Edward had his bad days and his worse days. Heart
failure made it difficult to catch his breath while
walking even short distances. All that changed after
he underwent a CardioMEMS heart procedure at
Vassar Brothers Medical Center more than a year ago.
“This spring, I’m busy working on my farm, getting
it ready for my parents to move back in with us.
I never would have even considered doing this over
a year ago.”
30

FROM THE HEART | Lauree and Sharon Ostrofsky
When Sharon was referred to the Cardio-Oncology
program, she was six rounds into chemotherapy for
non-Hodgkin lymphoma. There was concern that her
heart function had declined due to recent chemotherapy
and a heart valve replacement procedure several years
earlier. Lauree says: “It helped my mother and me feel
taken care of by a community of experts who had my
mother’s health in mind.”
Largest anticoagulation clinic in the Mid-Hudson Valley
Our dedicated staff of nurses at the Heart Center provides patients with expert and comprehensive
management of anticoagulation — whether with Coumadin or one of the non-vitamin K antagonists
(aka NOACs). Our staff also assists in periprocedural bridging management of anticoagulation for
patients undergoing surgical procedures.
ANTICOAGULATION
CLINIC NUMBERS
POUGHKEEPSIE
CLINIC
NEW
WINDSOR
CLINIC
FISHKILL
CLINIC
RHINEBECK
CLINIC
Daily visits 70 PATIENTS 30 PATIENTS 20 PATIENTS 15 PATIENTS
Annual encounters in 2015 13,050 4,969 2,846 2,084
31

From left: Carol Jorgensen, MA, RN; Cathy Kingsley, BSN, RN; Cynthia Delavalle, BSN, RN; Geri Kenny, MSN, RN, FNP-C
“At Vassar Brothers Medical Center, we are proud to be at the forefront of cardiac nursing
care in the Mid-Hudson Valley. The nurses dedicated to the specialty of cardiac care are an
inspiration to the profession, with an expertise that delivers care on a whole new level.”
— LORE BOGOLIN, MSN, RN, VP OF PATIENT CARE SERVICES, CHIEF NURSING OFFICER
FROM THE HEART | Kevin McCormick
An atrial fibrillation patient, Kevin had a catheter ablation
procedure performed at Vassar Brothers Medical Center.
“Words are inadequate to express my admiration and
respect for the doctors, nurses and staff of the hospital
for all their help and care. From my once irregular
beating heart, to my now regular beating heart, Vassar
Brothers Medical Center will always have my thanks.”
32

AT YOUR SERVICE
Physicians, Physician Assistants and Nurse Practitioners
THE HEART CENTER
Physicians
Joseph W. Christiana, MD, FACC, CPE
Ronald P. Cuffe, MD, FACC
Glenn J. Gerber, DO, FACC
Simon K. Gorwara, MD, FACC
Richard R. Gosselin, MD, FACC, FSCAI
Ethan L. Gundeck, MD, FACC
Kamran Haleem, MD, FACC
Ali Hammoud, MD, FACC
Mark A. Harrison, MD, FACC
M. Zubair Jafar, MD, FACC
Sanjaya Jha, MD, PhD, FACC
Louis W. Kantaros, MD, FACC
Douglas J. Kroll, MD, FACC
William Lee, MD, PhD, FACC
Sarah B. Levin, MD, FACC
Julie Ling, MD, FACC
James J. Lyons, MD, FACC
Anthony J. Messina, MD, FACC
Daniel J. O’Dea, MD, FACC
Anthony J. Patrello, MD
John Portelli III, MD, FACC
John T. Respass, MD, FACC
Benjamin Schaefer, MD, FACC
Lawrence W. Solomon, MD, FACC
Sankar N. Varanasi, MD, FACC, CCDS
Harshan Weerackody, MD, FACC
David J. Weinreich, MD, FACC
Michael H. Yen, MD, FACC, FSCAI
Physician Assistants
Deirdre McKibbin-Vaughn, PA
Nurse Practitioners
Preetha Alexander, ANP
Stephen Burns, FNP
Erin H. Gillen, DNP, FNP, ANP-BC, CCDS
Jaymie Imperato-Wilber, ANP
Laurel Kemp, FNP
Anne M. Lucas, DNP, FNP-C
Doris Maggiacomo, ACNP-BC
Rachel Moscicki, ANP
Stephanie C. Mulcahy, DNP, FNP-BC
Maria Noa, FNP
Rachel Paskey, FNP
Paula Portelli, ACNP-BC
Jennifer Schmidt, FNP-C
Dina Sedore, FNP
Sabrina Stent, NP-C
CARDIOTHORACIC SURGERY
Mohan Sarabu, MD, FACS, FACC
Rohit Shahani, MD, MCh, FACS, FACC
Peter Zakow, MD, FACS, FACC
Physician Assistants
Christopher Fillerup, PA
Atanas (Tony) Kostov, PA
Maria Kostova, PA
Alfred Menard, PA
Amanda Pazian, PA
Ronald Prince, PA
Mary Suleiman, PA
David Tecchio, PA
Adam Wiesenthal, PA
VASCULAR SURGERY
Mark J. Kulbaski, MD, FACS, RPVI *
Stephanie Saltzberg, MD, FACS *
Andreas M. Spirig, MD, FACS *
Britt H. Tonnessen, MD, FACS *
* The physician identified is neither an agent nor an employee of Health Quest or any of its affiliate organizations.
This physician has selected our facilities as the place where he wants to treat and care for his private patients.
33

IN THE HEART OF THE MID-HUDSON VALLEY
Locations
Vassar Brothers
Medical Center
45 Reade Place
Poughkeepsie, NY 12601
(845) 454-8500
Northern Dutchess Hospital
6511 Springbrook Avenue
Rhinebeck, NY 12572
(845) 876-3001
Putnam Hospital Center
670 Stoneleigh Avenue
Carmel, NY 10512
(845) 279-5711
The Heart Center,
a division of Hudson Valley
Cardiovascular, P.C.
1 Columbia Street
Poughkeepsie, NY 12601
(845) 473-1188
115 Delafield Street
Poughkeepsie, NY 12601
(845) 790-2020
6511 Springbrook Avenue
Suite 1006
Rhinebeck, NY 12572
(845) 876-0508
939 Little Britain Road
New Windsor, NY 12553
(845) 567-1800
60 Merritt Boulevard
Fishkill, NY 12524
(845) 897-9760
222 Route 299
Highland, NY 12528
(845) 473-1188
10 Healthy Way
Ellenville, NY 12428
(845) 647-2510
33 Grand Street
Kingston, NY 12428
(845) 339-8700
42084 State Route 28
Margaretville, NY 12455
(845) 339-8700
279 Main Street
New Paltz, NY 12561
(845) 339-8700
854 Route 212
Saugerties, NY 12477
(845) 339-8700
Health Quest Medical Practice
HQMP Division of
Cardiothoracic Surgery
1 Columbia Street, Suite 300
Poughkeepsie, NY 12601
(845) 483-0100
The Vascular Group
Vassar Brothers
Ambulatory Surgery Center
21 Reade Place, 2nd Floor
Poughkeepsie, NY 12601
(845) 483-0698
FROM THE HEART | Michael Gallo
Two days before Christmas, Michael was experiencing
chest discomfort so he had some tests performed. A
cardiac catheterization confirmed a 99 percent blockage
in one artery and 70 percent blockage in another. Two
stents were placed in Mike’s heart in the catheterization
lab, which set the stage for a great new year.
“Everyone — from admission to doctors, nurses and
housekeeping — was warm and friendly, explaining everything
to me and my family. Best Christmas gift ever.”
34

Jennifer Thietje, Director, Cardiothoracic Intensive Care Unit and Cardiothoracic Step Down Unit, says farewell to cardiac patient Linda Faber
as she is being discharged from the hospital
Vassar Brothers Medical Center stays at the heart of progress
with one goal in mind — to successfully bring our patients on
a journey from diagnostics to treatment to home.
35

TRANSFORMING HEALTHCARE ON THE HUDSON
The Vassar Brothers Medical Center Patient Pavilion
The Vassar Brothers Medical Center Patient Pavilion will help position our programs for the future,
with 264 state-of-the-art private rooms, 30 new ICU rooms, an expanded emergency department
and new operating rooms. The 696,000-square-foot tower promises a superior experience for patients,
families, physicians and staff, and represents a major step forward in the region’s healthcare.
NORTHERN DUTCHESS HOSPITAL
THE HEART CENTER
PUTNAM HOSPITAL CENTER