Establishment of a transcatheter aortic valve program and heart valve team at a Veterans Affairs facility

Faisal G Bakaeen, Biswajit Kar, Danny Chu, Lorraine D Cornwell, Alvin Blaustein, Glenn N Levine, David Paniagua, Hani Jneid, Corey Jensen, Prasad V Atluri, Carlos F Bechara, Panos Kougias, Chris Pawlak, Biykem Bozkurt, Thomas A Burdon, Blase A Carabello
American Journal of Surgery 2012, 204 (5): 643-8

BACKGROUND: The US Food and Drug Administration recently approved a transcatheter aortic valve for patients for whom open heart surgery is prohibitively risky.

METHODS: A multidisciplinary heart valve team partnered with administration to launch a transcatheter aortic valve replacement (TAVR) program. Clinical registries were used to show robust valve caseloads and outcomes at our Veterans Affairs (VA) facility and to project future volumes. A TAVR business plan was approved by the VA leadership as part of a multiphase project to upgrade and expand our surgical facilities.

RESULTS: The heart valve team completed a training program that included simulations and visits to established TAVR centers. Patients were evaluated and screened through a streamlined process, and the program was initiated successfully.

CONCLUSIONS: Establishing a TAVR program at a VA facility requires a multidisciplinary team with experience in heart valve and endovascular therapies and a supportive administration willing to invest in a sophisticated infrastructure.

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