Multisociety (AATS, ACCF, SCAI, and STS) expert consensus statement: Operator and institutional requirements for transcatheter valve repair and replacement, part 1: Transcatheter aortic valve replacement

PREAMBLEThe granting of staff privileges to physicians is an important mechanism to ensure quality care.The Joint Commission on Accreditation of Healthcare Organizations requires that medical staff privileges be based on professional criteria specified in medical staff bylaws.Physicians are charged with defining the criteria that constitute professional competence and with evaluating their peers accordingly.With the evolution of transcatheter aortic valve replacement (TAVR), an important opportunity arises for both cardiologists and surgeons to come together to identify the criteria for performing these procedures.The Society for Cardiovascular Angiography and Interventions (SCAI), American Association for Thoracic Surgery (AATS), American College of Cardiology Foundation (ACCF), and the Society of Thoracic Surgeons (STS) have, therefore, joined together to provide recommendations for institutions to assess their potential for instituting and/or maintaining a transcatheter valve program.This article concerns TAVR.As TAVR is in its infancy, there are few data on which to base this consensus statement.Therefore, many of these recommendations are based on expert consensus.As the procedures evolve, technology changes, experience grows, and more data is accumulated, there will certainly be a need to update this consensus statement.However, with the Food and Drug Administration (FDA) having just approved the first generation of TAVR devices, the writing committee and participating societies believe that the recommendations listed in this report serve as an appropriate starting point.In some ways, these recommendations apply to institutions more than to individuals.As there is a strong consensus that these new valve therapies are best performed using a team approach, these credentialing criteria may be best applied at the institutional level.Partnering societies used the ACCF's policy on relationships with industry and other entities (RWI) to author this document (http:// www.cardiosource.org/Science-And-Quality/Practice-Guidelines-and-Quality-Standards/Relationships-With-Industry-Policy.aspx).To avoid actual, potential, or perceived conflicts of interest that may arise as a result of industry relationships or personal interests among the writing committee, all members of the writing committee, as well as peer reviewers of the document, were asked to disclose all current health care-related relationships, including those existing 12 months before initiation of the writing effort.A committee of interventional cardiologists and surgeons was formed to include a majority of members with no relevant RWI, and be led by an interventional cardiology co-chair and a surgical co-chair with no relevant RWI.