Who should implant TAVI?
As we saw on “Does a cardiologist and a heart surgeon have the same responsibilities?”, two fields (Cardiology and Heart Surgery) that diagnose and treat the different types of heart ailments or in different stages of the therapeutic process.
What is a “heart team”?
Due to this common ground (but also different), the concept “heart team” has been created with the aim of taking advantage of these complementary specialties.
In some cases, this heart team can be enriched with other healthcare professionals of specialties that also participate on the process, as anaesthetists or intensivists.
Which specialty is responsible for TAVI? Who does indicate it? Who does implant it?
At this point, we have to distinguish between two stages of the TAVI process:
1.- diagnosis of the problem (aortic stenosis), TAVI indication and the election of the access route.
2.- implantation of the TAVI.
In most of the centres in Spain, the indication (evaluation of the TAVI and its route) is performed along with the Heart Surgery and the Cardiology unit (known as “heart team”).
Regarding the implantation, it depends on the route as we can use this technique on different routes (transfemoral, transapical, transaortic, transaxillary, etc.), but we will deepen on it in the next articles.
An important aspect when considering the role on both fields (Cardiology and Heart Surgery) is the managing of the complications, which will be a monographic subject. As we will see, many complications will require a Heart Surgery team, so performing this technique in centres where there is an experimented Heart Surgery team is a good practice. (See: “Map of the centres with surgical coverage”)