Position Statement for the Operator and Institutional Requirements for a Transcatheter Aortic Valve Implantation (TAVI) Program - 24/02/15

Doi : 10.1016/j.hlc.2014.09.009

Darren L. Walters ^a,^⁎ , Mark Webster ^b, Sanjeevan Pasupati ^c, Antony Walton ^d, David Muller ^e, Jim Stewart ^b, Michael Williams ^f, Andrew MacIsaac ^g, Greg Scalia ^a,^h, Michael Wilson ⁱ, Adam El Gamel ^c, Andrew Clarke ^j, Jayme Bennetts ^k, Paul Bannon ⁱ
^a Department of Cardiology, Prince Charles Hospital, Queensland 4032, Australia
^b Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand
^c Waikato Hospital, Hamilton, New Zealand
^d Victorian Cardiovascular Services Epworth Hospital, Victoria 3121, Australia
^e St Vincent's Hospital, New South Wales 2010, Australia
^f Dunedin Hospital, Dunedin, New Zealand
^g St Vincent's Hospital, Victoria 3065, Australia
^h Heart Care Partners, Queensland, Australia
ⁱ Cardiothoracic Surgery, RPAH Medical Centre and The Heart Care Centre, Sydney, New South Wales, Australia
^j Department of Cardiothoracic Surgery, Prince Charles Hospital, Queensland 4032, Australia
^k Flinders Medical Centre, South Australia 5042, Australia

^⁎Corresponding author at: Department of Cardiology, Prince Charles Hospital, Rode Road, Chermside 4032, Queensland, Australia. Tel.: +61 7 3139 4000, +61 400 842 777, fax: +61 7 3139 4715.

Résumé

The Cardiac Society of Australia and New Zealand (CSANZ) and the Australia and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) have joined together to provide recommendations for institutions and individual operators to assess their ability to initiate and maintain a transcatheter valve program. Transcatheter aortic valve replacement has been developed as an alternative to traditional surgical replacement of the aortic valve in high risk patients, particularly the frail elderly. The position paper has endorsed the important role of a multi-disciplinary “Heart Team” in selecting patients for TAVI as fundamental to the establishment of a successful program. The paper outlines recommendations for the cardiologist to have a background in structural intervention and the surgeon to have experience in high-risk aortic valve replacement. It is further recommended that TAVI programs be established in high volume cardiac surgical centres where on site valve surgery is performed. The paper is intended to provide guidance to individual operators and prospective institutions considering the establishment of a successful TAVI program.

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Keywords : Aortic stenosis, TAVI, TAVR, Transcatheter valve implantation