TAVR concerns: Cardiologists, patient family members question quality of care at rural hospital

Benefis Health System in Great Falls, Montana, is in the spotlight due to complaints about the quality of its transcatheter aortic valve replacement (TAVR) program.

How can rural hospitals compete with larger facilities in more urban parts of the country? Should less experienced physicians seek additional help when making important treatment decisions? Those are just some of the big questions explored in a new report from Montana Free Press.

The story focuses on Bette Albright, a 75-year-old heart patient who underwent an unsuccessful TAVR procedure and never fully recovered. According to the report, Albright presented with aortic regurgitation, but not severe aortic stenosis. The failed TAVR implant was believed to be due to a lack of calcium. 

Albright, still in significant pain, was later transferred to Salt Lake City. The care team there spent several hours working to help, but Albright was never able to truly bounce back. 

Small TAVR program failed to gain momentum—is now on pause

According to Montana Free Press, the TAVR program at Benefis Health System started to take shape in 2022. Multiple physicians who saw the program in action spoke to the publication, sharing concerns about how treatments were being chosen. They all declined to discuss specific cases. 

Steven Bailey, MD, a cardiac surgeon, told Montana Free Press that he quickly had reservations about the newly formed TAVR program. More time should have been spent reviewing each case, he thought, but his concerns were largely ignored.

“It was shortly thereafter that, suddenly, I was not suitable to be participating in the TAVR program,” Bailey said, as quoted in the report. “That seemed to me to be the overall atmosphere that occurred whenever someone questioned the TAVR statistics or questioned patient selection—that it was met with aggression, and it was not an open, collegial discussion. So that part was disappointing to me.”

Steven Goldberg, MD, a cardiologist who previously worked with Benefis Health System, shared similar complaints.

“I have concerns that there was a pattern of behavior that suggested that Benefis compromised appropriate patient care for multiple patients,” he said, as quoted by Montana Free Press. 

Representatives from the system defended the actions of its physicians when asked for this report. 

TAVR program on hold—for now

Benefis Health System has paused its TAVR program as it works to bring in more cardiovascular specialists. The goal is to restart the program soon and start offering TAVR once again.

Goldberg did emphasize that he thinks Great Falls needs a high-quality TAVR program. For now, however, due to “all of the negativity” and the “toxicity,” patients may need to continue traveling more than 150 miles away to experience the benefits of a healthy TAVR program.

The reporting from Montana Free Press is thorough and should be read in full. Click the link below for the entire story: