Tavr Procedure Room Requirements

Raising the bar for existing tavr programs.

Tavr procedure room requirements.

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. 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. Today s decision includes updated volume requirements for hospitals and physicians to begin and maintain tavr programs. Specifically the updated policy includes new volume requirements for reimbursable tavr programs.

Mep and electrical requirements shall be pursuant to the nec and ahj 4. 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. 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. Complete requirements for new tavr programs are available on pages 60 62 of the expert consensus document.

Blood products are to be available in room during procedure pre procedure hydration to prevent kidney injury chg bath completed. Aortic valve replacement tavr procedures in cardiac catheterization laboratories cardiothoracic surgery room specifications are required. 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. Criteria procedure pre post care sarah johnson rn msn acnp bc occurs when the heart s aortic valve narrows.

The primary tavr operator should be a member of the mdt at the designated new institution where he she spends at least 50 of his her active practice time. Transcatheter aortic valve replacement tavr is a minimally invasive procedure to replace the aortic valve in people with aortic valve stenosis. 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. The first in man studies were performed in 2002 and as such tavr is a relatively new procedure.

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.