The 2019 AATS/ACC/ASE/SCAI/STS Expert Consensus Systems of Care Document: A Proposal to Optimize Care for Patients With Valvular Heart Disease, published online recently in the Journal of the American College of Cardiology, suggests the need to develop a tiered system of hospitals performing valve procedures based on to-be-defined factors that include volume and outcome quality. For example, there would be Level I centers (Comprehensive Valve Centers) and Level II centers (Primary Valve Centers). Level I would comprise centers with significant imaging as well as surgical and interventional procedure experience, and these centers would be able to perform all types of procedures. In contrast, Level II centers would have less experience and would be expected to focus on more straight-forward types of procedures such as femoral transcatheter aortic valve replacement. Given this ongoing discussion, how do you feel about this concept?

References

1. Nishimura RA, O'Gara PT, Bavaria JE, et al. 2019 AATS/ACC/ASE/SCAI/STS Expert Consensus Systems of Care Document: A Proposal to Optimize Care for Patients With Valvular Heart Disease. J Am Coll Cardiol 2019;Apr 19:[Epub ahead of print].

Clinical Topics: Cardiac Surgery, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Valvular Heart Disease, Aortic Surgery, Cardiac Surgery and VHD, Interventions and Imaging, Interventions and Structural Heart Disease, Angiography, Nuclear Imaging

Keywords: Transcatheter Aortic Valve Replacement, Heart Valve Diseases, Aortic Valve, Heart Valve Prosthesis, Coronary Angiography

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