MPs, Clinicians and Charity Leaders join forces to launch a fast track pathway for heart valve disease

December 8th 2020

  • Heart valve disease affects 1.5 million people in the UK and is fatal if left untreated

  • Transcatheter Aortic Valve Implantation (TAVI) has been introduced as a less invasive procedure, reducing hospital resources - but access to TAVI is limited with profound geographical inequity

  • In 2019 alone, there were up to 450 deaths in the UK as a result of long waiting times for TAVI

  • Today, MPs, Clinicians and Charity Leaders launch Valve for Life, an initiative campaigning to fast track patients to TAVI

Aortic stenosis is a growing health problem and affects approximately 1.5 million people over the age of 65 in the UK [1]. Patients experience chest pain, shortness of breath, loss of consciousness [2] and if left untreated, it is fatal within two years of diagnosis [3].

Transcatheter Aortic Valve Implantation (TAVI) has been introduced as an alternative therapy to replace damaged aortic valves, in patients considered high risk for traditional open-heart surgery.[4] [5] The procedure is less invasive and patients can be discharged from hospital in a short period, allowing them to return to normal life whilst also saving hospital resources1 [6]. Despite the benefits of TAVI for high-risk patients, patient access to this procedure is limited in the UK with profound geographical inequity and long waiting lists, made worse by the Covid-19 Pandemic.

Patients have poor overall survival without TAVI or aortic valve replacement[7]. Studies have found that there is a significant risk of mortality while waiting for TAVI treatment and longer waiting times are associated with poorer outcomes for those who survive to intervention[8]. Currently, there is a 23% chance of mortality at six months waiting for TAVI and in 2019 alone there were approximately 450 deaths in the UK as a result of long waiting times for TAVI[9]. In the UK, patients can wait for 150 days (5 months) on average for TAVI treatment and this could be exacerbated by the current pandemic.[10]

Today, working alongside the new APPG on Heart Valve Disease, MPs, Clinicians and Charity Leaders joined forces to launch Valve for Life in the UK – focusing on the need to reduce waiting times for TAVI across the NHS; address the current geographical inequity; and reduce the very high numbers of patients dying while awaiting treatment. At the event policy-makers, healthcare professionals and prominent patient advocates from the heart valve disease space discussed the urgent need to establish a fast-track TAVI pathway for UK heart valve disease patients to tackle these challenges.

 

Speaking on the success of the event, MP Steve McCabe said: “I am very proud to chair the APPG on Heart Valve Disease and to support the launch of the Valve for Life initiative. Collectively, campaigning to ensure that more patients get access to TAVI will mean better outcomes for patients and less pressure on hospital resources. We are campaigning for a fast-track pathway akin to that used in oncology and we have clinical, parliamentarian and patient group support for change. From today’s meeting, I am feeling confident that we can make headway with making this a reality within our NHS by 2022.”

 

Dr Dan Blackman, who treats patients with Heart Valve Disease and is leading the Valve for Life initiative in the UK commented, “TAVI allows patients to have valve replacement under local anaesthetic, avoiding open-heart surgery and with a hospital stay of only two to three days on average, compared to eight days for surgery. TAVI also minimises use of pressured hospital resources, not only overall length of hospital stay, but also avoiding any need for use of ventilators or ICU beds, and therefore is ideally suited to the COVID and post-COVID era when pressure on NHS resources is huge, and the desire to avoid prolonged hospital stays is considerable on all sides. I’m hopeful from the discussions we’ve had today that we can make access to TAVI faster and fairer across the NHS, and by doing so can prevent many avoidable deaths.”

 

Pauline Summersall, aged 81, from Harrogate who has recently undergone TAVI and attended the event to address the group on the positive impacts of TAVI, said; “I spent years feeling breathless and just thought it was a sign of old age, I even struggled to walk to my sons house, five houses down my street and my life felt limited. It was not until I had a second opinion that I was referred onto a waiting list for surgery. I had expected to wait for a few months, but with Covid-19 restrictions this wait time was extended and I ended up collapsing at home before being rushed into hospital. The TAVI surgery and the care team were exceptional and I was able to come home the day after having the procedure done, instead of a having lengthy time in hospital. I am now back to living my life to the full and that is thanks to being able to have TAVI. This is something that more people need access to.”

References

[1] https://heartvalvevoice.com/application/files/3515/8436/3890/Heart_Healthy_Future_Report.pdf

2 https://www.nhs.uk/conditions/aortic-valve-replacement/whyitsdone/

3 https://www.bmj.com/content/354/bmj.i5085

4  https://newheartvalve.com/uk/explore-treatments/treatment-options/#:~:text=The%20only%20effective%20way%20to,such%20as%20open%20heart%20surgery

5 https://www.england.nhs.uk/wp-content/uploads/2013/04/a09-p-a.pdf

6 https://improvement.nhs.uk/documents/2898/Guide_to_reducing_long_hospital_stays_FINAL_v2.pdf

7 https://www.annalsthoracicsurgery.org/article/S0003-4975(14)01324-1/pdf

8 https://www.ahajournals.org/doi/10.1161/JAHA.118.010407

9 Data taken from 23 of the 25 UK TAVI centres. There were 299 deaths in these centres. Extrapolated to all 35 centres that would be a total of 455. However, we do not have the exact figure for all centres, hence this is an estimate

10 https://openheart.bmj.com/content/7/1/e001241