Interview with Ad van Boven

Why did you start TAVI procedures on Curaçao?
We started with TAVI as an emergency procedure. No heart surgery is available on the island and the nearest hospital is >1000 kilometers away by air.  Elderly patients with symptomatic aortic stenosis and heart failure could not be transported and an air ambulance is very expensive.  When several admitted aortic stenosis patients were about to die, it was decided by the board, government and insurance company to allow TAVI procedure on the island.  To stabilize one critical patient, a balloon angioplasty of the valve was performed 2 weeks prior to the TAVI. This method is of value since the TAVI team is not available every week. Thirteen patients have been treated and the results will be presented on CRES symposium.

The (dis)advantages of TAVI on Curaçao?
This highly specialized care is now available for fragile elderly patients, who had no access to this treatment before. TAVI has been proven to be safer compared to surgery and is cost effective. Transportation costs of patient and family are high and TAVI on Curaçao is cost saving. Due to assistance of experienced cardiologists there was no learning curve. In the near future the team can be selfsupporting. One disadvantage is shortage of material and personnel.

Is TAVI on Curaçao here to stay?
Yes of course! Like PCI TAVI has become a routine treatment. On Curaçao the referral of patients from all cardiologists is well organized. The board, insurance company, government and specialists work together to have excellent results and diminish costs. As soon as the new hospital is operational, our ambition is to become a referral centre for TAVI in the Caribbean region.