CT Surgeons Highly Engaged in TAVR Procedures, Survey Shows

chartAn STS survey has found that 77% of cardiothoracic surgeons are actively involved if a transcatheter aortic valve replacement (TAVR) program exists at their institution.

2016-2017 STS President Joseph E. Bavaria, MD will present an overview of the survey findings at this morning’s General Session. The 16-question survey was sent to 2,594 surgeon participants in the STS Adult Cardiac Surgery Database between June 27 and July 7, 2016; 487 (19%) responded.

In 2012, the Centers for Medicare & Medicaid Services issued a National Coverage Determination (NCD) for TAVR procedures. That NCD includes a provision to the effect that “the heart team’s interventional cardiologist(s) and cardiac surgeon(s) must jointly participate in the intra-operative technical aspects of TAVR.” The goal of the survey was to assess whether—for those cardiothoracic surgeons operating at hospitals where TAVR procedures are performed—an environment exists in which all members of the heart team are able to contribute effectively to the well-being of their patients.

As it turns out, TAVR truly is a multidisciplinary endeavor. A total of 84% responded that both cardiologists and cardiothoracic surgeons bring in potential TAVR patients, and 89% reported that two cardiothoracic surgeons independently examine and evaluate potential TAVR patients. Most respondents reported a TAVR caseload of up to 9 per month (41% had 5-9 cases, and 36% had 0-4 cases).

The survey also provided insight into the technical aspects of the operation performed by surgeons. Respondents said that they most often obtain alternative access (89%), perform open repair of femoral vessels, as needed (85%), and obtain femoral artery access (71%). Additionally, 87% of respondents participated in the postprocedural care of TAVR patients.

“Surgeons have been an integral component of the TAVR phenomenon, but the challenge now is to increase our role and attain lead operator status in many cases,” Dr. Bavaria said.

For more on this important survey, make sure to attend the General Session at 8:45 a.m. in the Grand Ballroom. A roundtable discussion on the topic also will be available on the STS YouTube channel later this year.

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