title: Establishment of a transcatheter aortic valve program and heart valve team at a Veterans Affairs facility.
abstract: BACKGROUND
  The US Food and Drug Administration recently approved a transcatheter aortic valve for patients for whom open heart surgery is prohibitively risky.
  
  
  METHODS
  A multidisciplinary heart valve team partnered with administration to launch a transcatheter aortic valve replacement (TAVR) program. Clinical registries were used to show robust valve caseloads and outcomes at our Veterans Affairs (VA) facility and to project future volumes. A TAVR business plan was approved by the VA leadership as part of a multiphase project to upgrade and expand our surgical facilities.
  
  
  RESULTS
  The heart valve team completed a training program that included simulations and visits to established TAVR centers. Patients were evaluated and screened through a streamlined process, and the program was initiated successfully.
  
  
  CONCLUSIONS
  Establishing a TAVR program at a VA facility requires a multidisciplinary team with experience in heart valve and endovascular therapies and a supportive administration willing to invest in a sophisticated infrastructure.
authors.affiliation: Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA. fbakaeen@bcm.edu
authors.forename: Faisal G
authors.initials: FG
authors.lastname: Bakaeen
authors.forename: Biswajit
authors.initials: B
authors.lastname: Kar
authors.forename: Danny
authors.initials: D
authors.lastname: Chu
authors.forename: Lorraine D
authors.initials: LD
authors.lastname: Cornwell
authors.forename: Alvin
authors.initials: A
authors.lastname: Blaustein
authors.forename: Glenn N
authors.initials: GN
authors.lastname: Levine
authors.forename: David
authors.initials: D
authors.lastname: Paniagua
authors.forename: Hani
authors.initials: H
authors.lastname: Jneid
authors.forename: Corey
authors.initials: C
authors.lastname: Jensen
authors.forename: Prasad V
authors.initials: PV
authors.lastname: Atluri
authors.forename: Carlos F
authors.initials: CF
authors.lastname: Bechara
authors.forename: Panos
authors.initials: P
authors.lastname: Kougias
authors.forename: Chris
authors.initials: C
authors.lastname: Pawlak
authors.forename: Biykem
authors.initials: B
authors.lastname: Bozkurt
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Burdon
authors.forename: Blase A
authors.initials: BA
authors.lastname: Carabello
mesh_terms: D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000191:economics / Q000601:surgery*; D004502:Education, Medical, Continuing; D057510:Endovascular Procedures / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D006787:Hospitals, Veterans / Q000191:economics / Q000458:organization & administration; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration*; D016730:Program Development / Q000191:economics / Q000379:methods*; D013781:Texas; D014481:United States; D014493:United States Department of Veterans Affairs