Surgical aortic valve replacement (AVR) is an effective treatment for severe AS. During the procedure, the damaged “native” heart valve is replaced with a prosthetic valve. Open heart AVR is recommended for virtually all adult severe AS patients who do not have other serious medical conditions. For patients who are determined to be at high risk or too sick for traditional open-heart surgery, the less invasive TAVR procedure is a treatment option.

The TAVR procedure enables the placement of this collapsible prosthetic aortic heart valve into the body via a tube-based delivery system called a catheter. The catheter can be inserted from a number of routes:

• through an incision in the femoral artery in the thigh and threaded up to the heart (transfemoral)
• through an incision between the ribs and then through a small incision in the bottom (apex) of the heart (transapical)
• through a small incision in the front of the chest and then through a small hole in the aorta (transaortic)

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 multidisciplinary 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.

• The cardiac surgeon determines the most appropriate candidates for TAVR. Surgeons typically perform transapical or transoartic TAVR in a modified cardiac catheterization lab or hybrid operating room (OR) aided by imaging equipment to assist with optimal valve delivery and placement. Surgeons play a critical role in facilitating optimal outcomes in transfemoral TAVR procedures by offering their surgical expertise, as needed.

• 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 or transaortic TAVR procedures by offering their interventional expertise, as needed.

• 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 Cardiac 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.

• Intensive Care Unit, Cardiovascular Interventional Unit or Cardiovascular Stepdown Unit nursing staff provide care while the TAVR patient is hospitalized following the procedure.

• The Cardiopulmonary Rehab staff promote faster patient recovery, and return to full and productive lives, by monitoring progress in activity and exercise performance and helping manage healthy lifestyle choices.
  
  
• Advanced Registered Nurse Practitioners in the MercyOne Genesis Cardiac Surgeons clinic, have additional training in critical and cardiac care, and work in concert with physicians in preparing patients for the TAVR procedure and in providing post-procedure follow-up care.
  
  
• The Valve Clinic Coordinator facilitates each step in the TAVR process by providing education and support to patients and their loved ones. The coordinator serves as the primary point of contact to patients and caregivers navigating the process from the time of referral through post TAVR follow-up care. The Valve Clinic Coordinator ensures communication is streamlined among the specialized Heart Team at MercyOne Genesis, the patient, and the referring physicians.