John Muir Health

The partnership between the cardiac surgeon and interventional cardiologist establishes the core of the TAVR Heart Team – a care team comprised of specialists from a number of disciplines that work together to facilitate optimal outcomes for each patient. This multi-disciplinary approach to patient care is a critical component in TAVR, as each specialist contributes an important area of expertise that plays an integral role in the collective care process.

Transfemoral TAVR Heart Team

• The cardiac surgeon determines the most appropriate candidates for TAVR. Surgeons play a critical role in facilitating optimal outcomes in transfemoral TAVR procedures by offering their surgical expertise as needed. Surgeons typically perform transapical TAVR in a cardiac cath lab or hybrid operating room (OR) aided by imaging equipment to assist with optimal valve delivery and placement.
• An interventional cardiologist (IC) works closely with a cardiac surgeon in the evaluation of potential candidates for TAVR. ICs play a critical role in facilitating optimal outcomes in transapical TAVR procedures by offering their interventional expertise as needed. ICs typically perform transfemoral TAVR in a cardiac cath lab or hybrid operating room (OR) aided by imaging equipment to assist with optimal valve delivery and placement.
• An anesthesiologist is responsible for ensuring safe delivery of anesthesia before and during the procedure, monitoring the patient during the procedure and overseeing post-procedure care.
• An echocardiographer uses ultrasound technology to examine and evaluate the function of the heart including valve function and blood flow.
• The cath lab and OR staff assist with device as well as room preparation, and closely monitor the patient and procedure environment both during and after the procedure.

Team Training

Core members of the Heart Team at every hospital selected to offer the Edwards SAPIEN Transcatheter Heart Valve must participate in a rigorous training program.

During this comprehensive program, clinicians are trained on appropriate patient selection for TAVR, procedure planning and device preparation. Before doctors are able to perform a procedure, they are required to receive training using a hands-on-simulator and must observe several cases performed by other certified doctors with TAVR experience. This rigorous process has been implemented and utilized with the introduction of the Edwards SAPIEN Valve in other parts of the world, to ensure the technology is utilized by skilled operators, so that optimal patient outcomes are achieved.