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STRENGTHENING TAVI BEST PRACTICES IN CANADA: UPDATED CCS POSITION STATEMENT AND QUALITY INITIATIVES

Presenter(s)

• 

  Anita Asgar, MD, MSc

  Director, Transcatheter Valve Therapy Research
  Université de Montréal
• Sandra L.

  Sandra Lauck, PhD

  Nursing
  University of British Columbia
• Maral O.

  Maral Ouzounian, MD PhD

  Cardiac Surgeon, Surgeon Scientist, Associate Professor of Surgery
• Harindra W.

  Harindra Wijeysundera

  Vice-President, Medical Devices and Clinical Interventions
• 

  Laurie Lambert, MPH, PhD

  Principal scientist
• 

  Malek Kass

  Director of Structural Intervention and TAVI
  St. Boniface General Hospital, Winnipeg, Manitoba
• Corey A.

  Corey Adams, MD

  Cardiac Surgeon
• 

  Robert Welsh, MD, FRCPC, FESC, FACC, FAHA

  Zone Clinical Department Head, Clinical Sciences and Interventional Cardiologist
  University of Alberta
• Jonathan A.

  Jonathan Afilalo, MD, PhD

  Assistant Professor - Department of Medicine, Division of Experimental Medicine

Aortic stenosis is the most common valvular heart disease in the elderly with increasing prevalence worldwide. Initially considered experimental, transcatheter aortic valve implantation (TAVI) has transitioned rapidly to the standard of care for many patients with severe symptomatic aortic stenosis (AS). In the past five years, the CCS Transcatheter Aortic Valve Implantation (TAVI) Quality Committee has succeeded in engaging multidisciplinary and national stakeholders to join in the development and measurement of quality indicators and contribute to a national dialogue to optimize the care and health service delivery for patients with complex valvular heart disease. Together, we made significant advances to leverage the clinical, administrative and policy expertise across all Canadian centres and regions, and demonstrated the feasibility and power of promoting a culture of national commitment to excellence. The purpose of this workshop is to build on this early work initiated by CCS, and mark the beginning of the next phase in promoting the quality of TAVI in Canada and discussing the evolution of the quality indicators to mirror the expanding indications In 2019, the Canadian Cardiovascular Society will be publishing its second position statement for TAVI in the Canadian Journal of Cardiology. This workshop will update the cardiovascular community on the content and recommendations stemming from that panel, with several members of the primary panel participating. This workshop will summarize the results of the 2019 Quality Report and recommendations from the 2019 CCS TAVI Position Statement and will provide an excellent opportunity for discussion with national leaders in TAVI.

Target Audience(s):

Cardiac surgeons, cardiologists and cardiovascular health professionals
Trainees
Health care administrators

Learning Objectives

At the conclusion of this session, participants will be able to:

• understand the changes and variation in measured TAVI quality since the inception of the TAVI Quality Report in 2016 to present day, and discuss strategies to overcome barriers to delivering care;
• discuss the revision of the TAVI quality indicators and methods to collect data using existing data structures i.e., CIHI; and
• describe the CCS recommendations regarding TAVI for patients undergoing TAVI in Canada;
• distinguish clinical scenarios that should be considered by a multidisciplinary Heart Team when determining the recommendation for transcatheter or surgical aortic valve replacement; and
• discuss the implications of expanding indications on the patient population with aortic stenosis including increased wait times and strategies to improve existing infrastructure.