Proposed TAVR NCD Should Drive Increased Volume Growth

Research evidence excerpt

Proposed TAVR NCD Should Drive Increased Volume Growth

art team composition experienced in AS care, each with clinical privileges at the hospital where TAVR is

AS care, plus other providers as appropriate.

performed. Other clinicians/research/admin staff may be included.

Cardiac surgeon and interventional cardiologist must each independently examine the Requires an initial heart team evaluation, which may be asynchronous using medical

Patient evaluation requirements patient face-to-face, evaluate suitability for SAVR, TAVR, medical therapy, or palliative records, plus an independent in-person evaluation by a heart team TAVR operator. Virtual

therapy, and document rationale. encounter cannot satisfy the operator evaluation.

Evaluation must consider SAVR, TAVR, close surveillance, palliative care, individual

Decision-making considerations Evaluation focuses on suitability for SAVR, TAVR, medical therapy, or palliative therapy.

clinical/anatomic/procedural factors, lifetime management, and estimated life expectancy.

The heart team’s interventional cardiologist(s) and cardiac surgeon(s) must jointly Joint participation of two TAVR operators is not required, but may occur if the heart team

Joint intraoperative participation

participate in the intraoperative technical aspects of TAVR. determines it is appropriate.

No simple ongoing individual operator-volume standard. Requirements are embedded in TAVR operator must be an interventional cardiologist or cardiac surgeon on the heart team

TAVR operator requirements heart team/program qualifications, including surgeon open-heart/aortic valve experience and must perform either ≥20 transcatheter cardiac valve procedures annually, including

and interventional cardiologist structural heart experience for new programs.