TAVR frequently asked questions for physicians

How is the access site determined, femoral artery versus apical?
How do you determine whether a patient receives the commercially available SAPIEN valve or participates in the PARTNER II trial?
What studies are needed in evaluating for TAVR? Can they be performed locally?
Does Providence Valve Center have a lot of experience with TAVR?
Whom do I call for more information or for referral?

How is the access site determined, femoral artery versus apical?
When the aorta, iliac arteries and femoral arteries are of sufficient caliber as determined by CT angiogram, the femoral artery access approach is preferred. For  patients with inadequate peripheral vessels, the valve can be delivered with the Ascendra Delivery System via an incision between the ribs through the apex of the heart (transapical procedure). The transaortic approach of direct aortic cannulation has also been used successfully at Providence Valve Center for deployment of the valve in situations with challenging anatomy.



How do you determine whether a patient receives the commercially available SAPIEN valve or participates in the PARTNER II trial?
Patients considered inoperable or high risk for surgery who are interested in proceeding with TAVR are treated per the FDA indication with the commercially available SAPIEN valve. 

Since Providence Valve Center participates in the PARTNER II trial of the next-generation SAPIEN XT valve, we are also able to offer TAVR to some patients not eligible for the commercially available device, including intermediate risk patients.

What studies are needed in evaluating for TAVR? Can they be performed locally?
The studies required for TAVR evaluation are:
  • Recent coronary angiogram and right heart catheterization
  • Carotid duplex ultrasound
  • Transthoracic ultrasound
  • Complete blood count and complete metabolic panel
  • Cardiac-gated CT angiogram with 3-D reconstruction of aortic valve, aorta, iliac arteries, femoral arteries
  • Pulmonary function testing (if significant lung disease)

With the exception of CT angiography, all studies can be performed locally by the patient's primary physicians.
 
Does Providence Valve Center have a lot of experience with TAVR?
At Providence Valve Center, we are proud to be first, and the largest TAVR program in the state. Some other notable facts:

  • The first transfemoral TAVR in Oregon, Feb. 1, 2012
  • The first transapical TAVR in Oregon, Aug. 21, 2012
  • The first "valve-in-valve" TAVR in Oregon, Feb. 7, 2013
  • The highest volume TAVR program in Oregon
  • The only PARTNER II clinical trial site in Oregon

Because of this, Providence Valve Center:

  • Provides the latest-generation technology though the PARTNER II clinical trial
  • Provides the greatest number of transcatheter valve sizes available in Oregon
  • Provides treatment to the largest range of patients (intermediate risk to inoperable)

Whom do I call for more information or for referral?
Please contact Providence Valve Center at 503-216-0790, or fax 503-216-0792.