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Jefferson Surgical Solutions

Toll Institute leadership: Drs. Salil Shah, Mauricio Garrido, Timothy Misselbeck, Joseph Bavaria, Alexandra Tuluca, Raymond Singer, Aaron Eckhauser. Not pictured: Dr. John Entwistle.

Through a transformational gift from the Bruce and Robbi Toll Foundation, Jefferson Health established the Bruce & Robbi Toll Heart and Vascular Institute in June 2024. This comprehensive program is designed to bring high-quality cardiovascular care directly to patients and communities in Jefferson’s vast and expanding service area. Led by Joseph Bavaria, MD, FACS, FRCS (Edin) ad hom, the Toll Institute is integrating cardiac and vascular services across the Jefferson enterprise – including Cardiology, Cardiac Surgery, Vascular Medicine and Vascular Surgery.

The unified structure will significantly enhance collaboration among care teams, streamline patient experience and increase access to promising clinical trials. It will also promote cross-disciplinary research and education across divisions, disciplines and clinical sites.

In January of this year, Dr. Bavaria joined Jefferson after spending more than three decades at Penn Medicine. Over the course of his career, he has performed more than 9,000 open-heart procedures and is a noted expert in treating thoracic aortic aneurysms and repairing and replacing aortic valves. Beyond the opportunity to continue helping patients, he is energized by the challenge of unifying cardiac and vascular care across Jefferson's 33-hospital system.

“The key question is how best to manage our cardiac and vascular services clinically,” he says. “Structures from a century or more ago – with classic departments and divisions – may not be the best framework for a health system of this size. We need a new way of looking at things.”

Through the institute, Dr. Bavaria and his team aim to make it easier for patients to access the appropriate level of care regardless of which location they enter Jefferson. They are also working to ensure that consistent protocols and quality metrics are applied across the system.

For clinicians, being part of a large, stable health system like Jefferson offers more flexibility and opportunities for collaboration. It also supports Jefferson Health’s commitment to clinical research, especially in the device-heavy field of vascular surgery. By leveraging the entire Jefferson enterprise, physicians can accrue more patients into trials.

It's critically important for large centers like ours to be involved in trial administration, publication and presentation of breakthrough treatments,” says Dr. Bavaria.

To patients, referring physicians and the community at large, Dr. Bavaria offers this message: “We have put together an organization where like-minded specialties come together in multiple domains to functionalize the entire super-regional system. The institute structure will allow seamless treatment of our patients at all levels within Jefferson.”

To learn more, please visit: JeffersonHealth.org/Clinical-Specialties/Heart-Vascular.


The Surgeon Speaks
Joseph E. Bavaria, MD, FACS, FRCS (Edin) ad hom
Anthony E. Narducci Professor and Chair, Department of Cardiac Surgery
Executive Director, Bruce & Robbi Toll Heart and Vascular Institute

“The scale of the Toll Institute offers the advantage of higher case volumes, which enables surgeons to specialize technically. This is especially important in cardiac surgery, where there are numerous subspecialty programs that are critical to the patients who need them while also being strategically important to the institution.

“In a smaller system, there may not be enough case volume to justify a two-surgeon program. But at Jefferson, we have the scale to maintain more of these specialized programs with multiple surgeons. That translates into better working conditions for our clinicians, as well as more options – and better outcomes – for cardiac patients.”

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