The CFA Perspective

CMS announced its long-awaited updated transcatheter aortic valve replacement (TAVR) national coverage determination (NCD) final rules on June 21, 2019. 

Over the last few years, we have continued to blog to keep readers up to date on the evolving state of cardiac valve surgery and the development of transcatheter aortic valve replacement (TAVR) specifically. 

Occasionally, CFA will highlight a few significant news articles on cardiovascular topics -- clinical or organizational.

CMS announced its long-awaited updated transcatheter aortic valve replacement (TAVR) national coverage determination (NCD) proposal on March 26, 2019.  

In our continuing series on low-volume cardiac surgery programs (LVCS), we previously discussed structural heart programs and the importance of valve surgery volumes in the overall assessment of potential cases.

While low-dose coronary artery calcium scoring scans (CAC) using CT have been around for some time, their effectiveness and relatively low cost in assessing cardiac risk seems to be taking on a new life.  Accumulated wisdom and several newer studies have added to the body of clinical knowledge about CAC. 

Overview

According to the Society for Thoracic Surgeons (STS) Adult Cardiac Surgery Database: 2018 Update on Outcomes and Quality, across the 1,119 participating cardiac surgery programs in the database, the average adult cardiac surgery procedure volume in 2016 was 200.8 cases.

Overview

Advances in coronary heart disease (CHD) prevention, diagnosis and treatment has progressed significantly over the past two decades. 

Hospitals with small to medium-sized cardiac valve surgery programs need to know that the era of TAVR for most or all aortic valve replacement cases (AVR) – regardless of overall risk category – is moving ever closer to reality.

Two recent developments are important for those hospitals monitoring Transcatheter Aortic Valve Replacement (TAVR) developments.