Planning for hospital renovations offers unique challenges, and the CHI St. Vincent cardiac operating room expansion and renovation was no exception. The project was adjacent to an existing OR suite and two critical care units, meaning intense and careful planning was required to avoid interference with operations and ensure infection control. The four state-of-the-art cardiac operating suites required a complete demolition and renovation with new electrical and HVAC systems. One of the ORs is Arkansas’s first and largest cardiac hybrid ORs.