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Valve Clinic Supports TAVR Program

North Kansas City Hospital recently opened a cardiac Valve Clinic to support its transcatheter aortic valve replacement program, the only one in the Northland. Since its inception in July, the TAVR team has evaluated several patients; some were referred for open heart surgery while others underwent TAVR. The Valve Clinic staff serves as the primary contact for referrals and coordinates with patients and their families.

Who Qualifies for TAVR

“It’s important for physicians to refer patients to the Valve Clinic for evaluation,” says Zafir Hawa, MD , FACC, FSCAI, a cardiologist with Meritas Health Cardiology and a member of the TAVR team. “We know the criteria. Not everyone will qualify for a TAVR procedure, and we recommend what is best for the patient. It’s about taking care of people; it’s what we do.”

SAVR vs TAVR

If an ECHO evaluation indicates severe aortic stenosis and TAVR is indicated, a cardiologist orders several additional tests before the patient is seen in the Valve Clinic.

  • TAVR CT of the chest, abdomen and pelvis 
  • Carotid Doppler 
  • Spirometry 
  • EKG

Unique Environment

The Valve Clinic fosters a unique environment between cardiologists and cardiothoracic surgeons who team up to review test results and consult with patients and their families. “Working together, we experience each other’s perspective,” Dr. Hawa says. “We jointly review the data and then create a plan that’s right for the patient.”

If additional testing is necessary to help determine the viability of TAVR, Dr. Hawa performs a balloon valvuloplasty as a surgery prelude to stratify the risk to the patient.

Collaborative Care

“Our goal,” Dr. Hawa says, “is to give patients better cardiac health and get them back to their primary cardiologist.” In the NKCH TAVR program, referring cardiologists have the option to conduct diagnostic tests themselves or allow the TAVR team to complete them. To keep communication open, the referring physician receives:

  • Consult letters
  • Operative Notes
  • Ongoing communication with Ashley Hinkle, Valve Clinic coordinator

Ashley Hinkle, RN, BSN, manages the clinic, completes referral intakes and serves as the information, education and training source for patient and their families. Ashley also serves as the patient liaison by coordinating pretesting and follow up visits.

Changing Lives

The time between initial testing and surgery is usually less than a month. And, patients are back on their feet quickly, usually within 2-3 days. “The difference in patient recovery between TAVR and sternotomy is incredible,” Dr. Hawa says. “TAVR patients often talk and joke with us an hour after surgery. They are discharged in 2-3 days and enrolled in cardiac rehab a week later. The difference in these patient’s lives is truly amazing.”

Follow up schedule:

  • Check incisions, adjust medications and start cardiac rehab: 1 week post-discharge
  • ECHO: 1 month post- discharge 
  • General assessment: 1 year

Zafir Hawa, MD, FACC, FSCAI

Zafir Hawa, MDDr. Hawa earned his medical degree from the University of Mumbai School of Medicine at Bombay, India. He completed his residency at the University of North Dakota Medical Center at Fargo, and a cardiology fellowship at Western Pennsylvania Hospital at Pittsburgh. He received TAVR training at the German Heart Center Munich (DHM) and is a Fellow of the American College of Cardiology and of the Society for Cardiovascular Angiography and Interventions.

To learn more, call 816.691.4015.