Less than a decade after performing the first transcatheter aortic valve replacement (TAVR) at the Brigham, a multidisciplinary team in the BWH Heart & Vascular Center recently became the first in New England to have completed 1,000 TAVR procedures.
Now with the largest program of its kind in the region – based on annual volume and total TAVRs performed – the Brigham’s TAVR team recently held a staff celebration in honor of its 1,000th case, which it achieved earlier this year. The program is now rapidly approaching 1,200 procedures.
“This milestone makes me realize that I am part of a progressive and talented group of individuals who have developed one of the country’s best TAVR programs,” said cardiac surgeon Marc Pelletier, MD, and the program’s surgical director. “The number 1,000 gives us pause to realize the amount of work needed to get here and how many patients and families have been helped by this groundbreaking technology.”
A minimally invasive surgical procedure performed in the Cardiac Catheterization Lab, TAVR is used to treat patients with a heart condition called aortic valve stenosis. Among these patients, blood is unable to flow freely from one of the heart’s valves to the body’s main artery, the aorta. Some patients with this condition can avoid open-heart surgery with the use of TAVR, which uses advanced imaging to help specialists guide a catheter into the heart – through a small incision in the leg, groin or chest – and insert a replacement aortic valve.
TAVR can be done without general anesthesia, and patients experience a quicker recovery than they would from a traditional open-heart valve replacement. The entire procedure takes about 90 minutes, and patients are often home within a day or two.
The Brigham performed its first TAVR in 2009 as part of a landmark, multi-institutional series of clinical trials known as the PARTNER trials. Following approval by the U.S. Food and Drug Administration, the procedure moved into clinical service at BWH in 2011.
Maximizing access to this lifesaving treatment is a major focus for the team, noted interventional cardiologist Pinak Shah, MD, who serves as the program’s medical director. The program now runs three clinics per week for patient evaluation, and TAVRs are typically done within two to three weeks of the patient’s first appointment.
“We can do this because of our ability to perform TAVR procedures five days per week, which is unusual in this field,” Shah said. “This is a testament to the dedication of everyone involved in the process – from clinic scheduling to radiology to procedure scheduling and catheterization laboratory staff.”
Pivotal to the BWH TAVR team’s success has been its focus on multidisciplinary collaboration, said cardiac surgeon Tsuyoshi Kaneko, MD.
“I am really proud of how much we’ve grown, but more than that, it’s the phenomenal teamwork,” Kaneko said. “To perform this procedure, it’s not just cardiac surgeons. It’s not just interventional cardiologists. We have an incredible team that includes anesthesiologists, nurses, non-interventional cardiologists, physician assistants, radiologists, fellows and many more. Everyone has contributed so much to the growth of this program.”
Pelletier and Shah agreed, noting that the team’s comprehensive approach and combined expertise enable them to assess referrals quickly and support faster, smoother recoveries for patients.
“It is a tremendous honor to be a part of this milestone and program, which is the ultimate example of cross-disciplinary collaboration,” Shah said. “It is very satisfying to work with such talented colleagues who have a common goal of building a successful program and providing great care for our patients.”