Planning and Developing a Successful TAVR Program at Maine Medical Center: Economic, Program, and Procedural Considerations


Cath Lab Digest talks with David W. Butzel, MD, FACC, co-director of the TAVR program at the Maine Heart Valve Center of Maine Medical Center; Claire M. Berg, MS, RN, CCRC, Maine Heart Valve Center Coordinator, and Kathleen Black, RN, OR Clinical Manager Cardiac/Thoracic Vascular Transplant and Endovascular, Maine Heart Valve Center, Portland, Maine.

As Cath Lab Digest talks with key members of the successful TAVR program at the Maine Medical Center, a tertiary referral hospital, we will focus on the pre, peri and post procedure processes that lead to the most efficient care of the patient, as well as the importance of collaboration and communication among various departments.

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Standard Screening Tool for Peripheral Artery Disease (PAD) Can Identify Patients at Higher Risk of Functional Decline and Disab

Experts call for rethinking of clinical threshold for “normal” ABI

People with borderline or low normal ankle-brachial index (ABI) — the ratio of systolic blood pressure at the ankle compared to that in the arm — who are considered “normal” based on current screening guidelines have a two- to three-fold higher risk for mobility loss, according to data published in the March 24, 2009 issue of the Journal of the American College of Cardiology.

“This study confirms that patients with peripheral artery disease, defined as an ABI value below 0.90, experience si

ESC statement: Explaining trends in heart attack: prevention has improved, mortality rates are down, hospitalization remains the

A report in Circulation from the Framingham Heart Study, which compared acute myocardial infarction (AMI) incidence in 9824 men and women over four decades, has proposed an explanation for the apparent paradox of improved prevention, falling mortality rates but stable rates of hospitalization.(1) The study found that over the past 40 years, rates of AMI diagnosed by ECG decreased by 50%, whereas rates of AMI diagnosed exclusively by infarction biomarkers doubled. This “evolving” diagnosis of AMI, say the investigators, “offers an explanation for the apparently steady national AM

Large-Scale Data Show CAS Achieves AHA Guideline Standards: SCAI statement

Carotid artery stenting (CAS) has demonstrated outcomes consistent with the American Heart Association’s (AHA) long-established guidelines for treatment of patients who have blockages in their carotid arteries and are at risk for standard carotid surgery, according to an analysis of two large, prospective studies published online in Circulation: Cardiovascular Interventions. Based on these and other data, the Society for Cardiovascular Angiography and Interventions (SCAI) is calling on the Centers for Medicare and Medicaid Services (CMS) to expand coverage of CAS to include all Food and Drug

New Genomic Markers Associated with Risk of Heart Disease and Early Heart Attack

Five short reports published simultaneously by the journal Nature Genetics have for the first time identified clusters of genetic markers associated with heart attack and coronary heart disease. In one of the reports, from the largest ever study of its kind, the Myocardial Infarction Genetics Consortium identified nine precise genes associated with an increased risk of infarction (MI), three of them newly discovered; the investigators said that these nine gene variants "identify 20% of the population at 2.25-fold increased risk for MI".

This study set out to find "single letter" di

Systolic and Diastolic Blood Pressures Together More Useful for Predicting Cardiovascular Risk

Individuals with diastolic blood pressure under 70 mm Hg coupled with an elevated systolic blood pressure may have a greater risk of heart attack and stroke than indicated by the systolic blood pressure values alone, according to a UC Irvine study.

Dr. Stanley Franklin and colleagues at the UC Irvine Heart Disease Prevention Program in conjunction with researchers at the Framingham Heart Study reviewed blood pressure data from 9,657 participants in the Framingham Heart Study who had not received antihypertensive treatment and found that the combination of low diastolic and high systolic num

Adoption of PCI in AMI Patients to Drive Drug-Eluting Stent Use

Nearly 150,000 PCIs were performed on AMI patients in 2008

According to Millennium Research Group’s (MRG’s) US Markets for Interventional Cardiology Devices 2009 report, the use of drug-eluting stents will continue to climb steadily through 2013, driven in large part by the adoption of primary percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) patients, who accounted for nearly 150,000 PCIs in the U.S. in 2008.

In the past, primary PCI — defined as a PCI performed within 24 hours of the onset of symptoms — was mostly limited to facilit

SCAI Statement on the Occluded Artery Trial (OAT)

When it comes to a heart attack, every second counts. The Occluded Artery Trial (OAT) underscores how very important it is for individuals experiencing a heart attack to take their symptoms seriously, call 911, and undergo prompt treatment. The OAT study examined a minority of heart attack patients who received very delayed treatment for heart attack (12 or more hours following heart attack onset). Less than one-third of heart attack patients fall into this specific category of patients.

The OAT study did not even address all of these patients:

• 83% of the patients entered into the tr

Stenting Not Necessary in Late Treatment of Heart Attacks

Two years ago, a major study found that many patients who receive delayed treatment for a heart attack do just as well with drugs alone as they do with drugs plus stents to prop open their blocked arteries. Now, further analysis shows that the drug option is cheaper and that there is no meaningful long-term difference in quality of life between the two options.

“The finding is just one more reason to question the use of routine stenting in late-treatment patients when cheaper, less invasive options are just as effective,” says Daniel Mark, MD, a member of the Outcomes Research Group at