Tavr Procedure Room Requirements

Tavr treats the stenotic heart valve by displacing and functionally replacing the native aortic valve with a bioprosthetic valve delivered on a catheter via a percutaneous transarterial approach through a peripheral artery e g the femoral artery.

Tavr procedure room requirements.

The first in man studies were performed in 2002 and as such tavr is a relatively new procedure. Aortic valve replacement tavr procedures in cardiac catheterization laboratories cardiothoracic surgery room specifications are required. For hospitals without tavr experience cms will require the tavr program to have performed at least 50 open heart surgeries and 20 or more aortic valve related procedures in the two years preceding tavr program initiative. Criteria procedure pre post care sarah johnson rn msn acnp bc occurs when the heart s aortic valve narrows.

Laboratories will be evaluated on an individual case by case basis. Transcatheter aortic valve replacement tavr is a minimally invasive procedure to replace the aortic valve in people with aortic valve stenosis. Since tavr is so new there are no specific guidelines on how many procedures are needed before a clinical center operator becomes proficient in tavr. Mep and electrical requirements shall be pursuant to the nec and ahj 4.

As more tavr programs have emerged it s become even harder for new players to meet these volume requirements particularly the current ncd s requirement for 50 surgical aortic valve replacement savr procedures a year as these procedures are often shifting to tavr sites. However since this is a highly complex procedure tavr should be performed only in centers that currently and routinely perform large volumes of surgical aortic valve operations see table 1. In developing today s decision cms met with numerous stakeholders including medical professional societies who recommended requirements for hospitals and physicians to perform a certain volume of heart procedures. Today s decision includes updated volume requirements for hospitals and physicians to begin and maintain tavr programs.

Beginning in their third year existing tavr programs will be expected to meet a higher bar for demonstrating competency in terms of volumes and outcomes to continue performing. Specifically the updated policy includes new volume requirements for reimbursable tavr programs. Aortic valve stenosis or aortic stenosis occurs when the heart s aortic valve thickens and calcifies preventing the valve from opening fully which limits blood flow from your heart to the. Raising the bar for existing tavr programs.

A specific requirement for the initiation of a new tavr site is a full time board eligible or certified in interventional cardiology or cardiothoracic surgery primary tavr operator.