From an interview with 
Dr. William C. Jackson
McLeod Vascular Associates Florence

Involving multiple specialists can garner better outcomes for replacing heart valves using Transarterial Valve Replacement (TAVR). McLeod Vascular Surgeon Dr. William C. Jackson explains the “Structural Heart Program.”

Here is a summary of Dr. Jackson’s comments:
A structural heart program is usually comprised of 1) a cardiologist, who specializes in the treatment of the valves in the heart, 2) a cardiac surgeon or heart surgeon, who assists in the deployment of the replacement valve and the workup of the patients, since cardiac surgeons have a history of caring for patients with severe valve disease and 3) vascular surgeons, because patients who need heart valve replacement may also have vascular disease that requires vascular surgery to undertake this procedure.

We are seeing patients with more severe disease, so a multi-disciplinary approach is more important now than ever. Patients need evaluation by the cardiologist, the cardiac surgeon and, often, by a vascular surgeon. And that’s important because with TAVR, we go through the arteries, using catheters, wires and stents to replace the valve and treat the stenosis rather than open the chest to repair the valve.

In patients, who have small arteries, severe calcification, narrowing or arterial blockages, the cardiac surgeon may not be able to gain easy access through the artery. As a vascular surgeon, I evaluate these patients to see if they are a candidate for TAVR. The question becomes if they’re not a candidate, how can we make them a candidate? And then, how can we help get this procedure done safely and get the patient the best possible outcome?
 
Really, the whole desire in the multi-disciplinary, multi-surgeon or multi-provider approach we have here at McLeod is to bring these patients the best outcome, the safest procedure and the most durable operation possible.

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