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Early Experience of TAVR arising from A Long Standing Valve Clinic in a Veteran Population

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Early Experience of TAVR Arising from Long Standing Valve Clinic in a Veteran Population

•Transcatheter aortic valve replacement (TAVR) has emerged as an increasingly utilized strategy for treatment of severe aortic stenosis in high risk surgical candidates
•We report our early experience in a Veteran population utilizing a long-standing multidisciplinary valve clinic as a means for patient selection
•Retrospective review of all patients who underwent TAVR at our institution after presentation in our institution’s multidisciplinary valve clinic which includes dedicated:
     •Valve surgeon
     •Noninvasive imaging cardiologist
     •Cardiac MRI/CT cardiologist
•Study Period: August 2014 to November 2015
•Average Age: 76 ± 9.8 years
•85% of patients were NYHA class III with the remainder class II
Of the 14 cases identified, 12 patients underwent aortic transcatheter valve replacement (9 TF-TAVR, 1 TA-TAVR, 2 TA-VIV-TAVR) with the SAPIEN transcutaneous valve and 1 patient underwent  mitral transcatheter valve  replacement (TMVR)
•Of the 12 procedures performed, there were no cases of 30-day mortality, stroke, MI, prosthetic valve endocarditis, or conversion to surgical aortic valve replacement.
•Heart failure class improved at 30 day follow up in all but one patient
•On follow up analysis which was 100% complete, there were no deaths (mean duration 9.9 ± 4.3 months; range 3-17 months)
•Early experience with transcatheter aortic valve replacement within a high risk Veteran population demonstrates that the procedure is safe and effective
•100% survival rate highlights the benefits of a multidisciplinary valve conference to optimize patient selection for TAVR
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