CTSNet hosted a webinar on September 15, 2026, titled “The TAVR Heart Team in 2026: Navigating the CMS Decision,” featuring leading surgeons Tom B. Nguyen, Michael Mack, and Tsuyoshi Kaneko, and cardiologist Martin B. Leon. The panel discussed the US Centers for Medicare & Medicaid Services (CMS) decision on the mandatory dual-operator requirement for transcatheter aortic valve replacement (TAVR). This webinar analyzed the new ruling and its direct impact on clinical practice and the TAVR Heart Team.
Throughout the presentations, the live audience submitted questions to the faculty, and the session concluded with a Q&A. Watch the full webinar to hear the panelists discuss this crucial decision in greater detail and answer audience questions.
Moderator:
- Tom C. Nguyen, MD, Chief Medical Executive, Director of Minimally Invasive Valve Surgery, Baptist Health Miami Cardiac & Vascular Institute, Miami, Florida, USA
Panelists:
- Michael Mack, MD, Medical Director, Department of Cardiothoracic Surgery, Baylor Scott & White Health, Dallas, Texas, USA
- Martin B. Leon, MD, Professor of Medicine, Interventional Cardiology, Director of the Cardiovascular Data Science Center, Columbia University Irving Medical Center, New York, New York, USA
- Tsuyoshi Kaneko, MD, Chair, Cardiovascular Disease, Chief, Section of Cardiac Surgery, Barnes-Jewish Hospital, Washington University in St. Louis Medicine, St. Louis, Missouri, USA
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14 Comments
Submitted by Ansar Hassan: How is the surgeon of today and tomorrow best suited to be a respected partner in the structural suite?
Submitted by Ansar Hassan: Should current surgeons go back and train?
Submitted by Trung Pham: Will we see a divergence in quality of TAVR outcome between those done at the high-volume hubs vs low-volume spokes?
Submitted by Trung Pham: Will we see the “over-TAVR’ing” of lesions of questionable clinical significance?
Submitted by Isaac George: What model is fair and equitable if surgeons do not have catheter skills?
Submitted by Isaac George: Should all patients with AS be seen by cardiology and surgery?
Submitted by Isaac George: If TAVR can be done without anesthesia/echo/same day discharge, should the reimbursement be reduced?
Submitted by Ourania Preventza: Would the surgeon remain in the OR during the procedure, or would their presence be limited to specific steps/none?
Submitted by Ourania Preventza: Could you clarify how reimbursement would be structured for the procedure and the respective roles involved?
Submitted by Ourania Preventza: Can someone explicitly state, in one operator cases, what that operator typically does in the procedure? And who does what the operator doesn’t? Who is #1 and who is #2?
Submitted by Amjad Syed: How are these changes going to impact the training for the CT Surgery Fellows and for that matter for Interventional Cardiology Fellows?
Submitted by Yasmine Osman: Instead of billing as co-surgeons, could the cardiac surgeon bill as an assisting surgeon (modifier 82), with 16% RVUs going to surgeon and 100% to the main operator (IC in this example)?
Submitted by Anonymous: With the companies now off the hook for symptomatic AS CED, who will pay for the TVT in the future? How will we ever know without TVT the outcomes of TAVR in Sx BAV pts, V-in-V cases, TAV-in-TAV cases?
Submitted by Anonymous: Isn’t the most valuable role of the surgeon weighing in during the initial assessment about most appropriate therapy, and being accountable for the ultimate patient outcome?