Finally, After Nearly Two Years…!

By Bernie Blocker, RCIS, Banner Good Samaritan Medical Center, Phoenix, Arizona

Yes, it has been nearly two years since I first wrote about Banner Good Samaritan Medical Center’s initial experiences with transcatheter aortic valve replacement (TAVR) [read the first entry in Bernie's blog here] and a lot has transpired during that time. Before I go too far, I’ll give a quick summary of where we started, the challenges we faced, and how we handled all of these new experiences.

Banner Good Sam’s TAVR team began implanting the Medtronic CoreValve in the later part of 2011. Initially, a standard cath lab room was used as the valve implants room (along with the many challenges that came along with that) until our hybrid OR became available a short time later. The cath lab team and heart surgery team struggled slightly in the beginning while we figured out each other’s routines, personalities, and work style. Ultimately, the cath lab and heart surgery team began working together like a well-oiled machine and, what once seemed to be an unlikely union has now enriched our work environment and inter-department relations.

Within 6 months of implanting the first CoreValve, our team also began implanting the Edwards Sapien valve. Thanks to our experiences with the CoreValve, the Sapien valve was easily integrated into our lab, and learning the new product and procedure was much easier. Recently, the Good Sam TAVR team has reached a milestone. To date, we have successfully implanted over 200 heart valves, between the two devices. By having both devices available to use, our doctors can decide the best approach to take for valve implantation. The CoreValve allows us to use a trans-femoral, trans-subclavian, or direct aortic approach. The Sapien valve provides the doctors the option to implant the valve by going trans-femoral or trans-apical. The variety of approaches we can use by having both valves helps our physicians treat more patients in the best way possible.

      Currently, our TAVR program is in full swing. On average, we implant valves one to three days per week. Having successfully worked together with many different healthcare providers such as cardiologists, cardiac surgeons, anesthesiologists, cardiac surgery team members, perfusionists, researchers, our TAVR coordinator, and the valve representatives, I’m proud to say we are a dynamic, fluid, and multitalented TAVR team. Our teams have really come together to provide our patients with the best care possible and work together effectively and efficiently. I believe the key to our TAVR program’s success lies in the ability of the cardiologists (including cath lab staff) and the cardiac surgeons (including OR staff) coming together and finding a common ground on which to treat their patients. This symbiotic relationship allows our patients to receive a treatment that will allow them to live with fewer symptoms, be more comfortable and active, and enjoy their lives more fully.

Email Bernie Blocker, RCIS, at