Renovations to the Cardiac Catheterization Suite at Good Samaritan Hospital Medical Center including equipment replacements in two existing Cardiac Catheterization Labs, the creation of a new Hybrid Operating Room / Cardiac Catheterization Lab for TAVR procedures and alterations to associated support spaces. Maintaining operation of one Cardiac Catheterization Lab at all times throughout these major alterations was a key project requirement. To acheive this goal, a three phased design approach, including several sub-phases, was developed with Hospital Engineering and the end users. Bladykas Engineering provided contract documents including demolition and new work drawings for each phase, ensuring that air exchange rates and pressurization were maintained at all times throughout the operational portions of the Cardiac Catheterization Suite.