At the Institute, TAVR is driven by consensus on what is the best treatment for a particular patient. Each week, a TAVR meeting brings all the brainpower and imaging power into one room to decide on whether a patient should undergo the procedure.
A range of medical disciplines come together to build consensus, including interventional cardiologists, clinical cardiologists, structural cardiologists, the cardiologists who actually do the TAVR procedures, heart surgeons, interventional radiologists, echocardiographers, nurse practitioners, and in some contexts, there are social workers.
“There’s a very long list of people, each with different areas of expertise, that help inform the best decision making for the patient,” says Marcus St. John, M.D., a cardiologist and Medical Director of the Cardiac Cath Lab at the Institute. “It really is an excellent opportunity, unbeknownst to them, to have a lot of people thinking about what is the very best way to manage this particular patient’s problem.”
A case is presented to the group by a clinician who has evaluated the patient. “The clinical details are presented, we review the CT scan of the aortic valve and the peripheral arteries, we look at the echocardiographic data to assess the aortic valve, we look at the cath data, and then we make a judgment as to whether this patient is a candidate for the aortic valve replacement procedure and what is the best approach for that particular patient,” says Dr. St. John.