Tavr Procedure Room Requirements

Today s decision includes updated volume requirements for hospitals and physicians to begin and maintain tavr programs.

Tavr procedure room requirements.

Transcatheter aortic valve replacement tavr is a minimally invasive procedure to replace the aortic valve in people with aortic valve stenosis. 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. Raising the bar for existing tavr programs. 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.

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. 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. Complete requirements for new tavr programs are available on pages 60 62 of the expert consensus document. Specifically the updated policy includes new volume requirements for reimbursable tavr programs.

Blood products are to be available in room during procedure pre procedure hydration to prevent kidney injury chg bath completed. Mep and electrical requirements shall be pursuant to the nec and ahj 4. 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. 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. 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. Criteria procedure pre post care sarah johnson rn msn acnp bc occurs when the heart s aortic valve narrows. 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.

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.