40,000 patients refused keyhole heart valve surgery –

More than 40,000 Brits needing a new heart valve do not have a life-saving procedure despite having been on the NHS for over 15 years.

Sick patients suffering from aortic valve stenosis have been considered too old or frail to survive traditional open heart surgery when one of the heart’s crucial valves narrows and reduces blood flow throughout the body.

However, keyhole surgery is rarely offered, which is safer and less invasive, but also more expensive.

The Mail on Sunday found that only 7,000 of these procedures, called transcatheter aortic valve implantation (TAVI), occur each year, according to NHS data.

Charities say patients on the waiting list have died due to the backlog of work they believe is due to NHS heads’ refusal to devote more money to the procedure.

Aortic valve stenosis is usually caused by a buildup of calcium, a mineral found in the blood, in the heart valve.

This of course increases with age in most people, but smoking, high blood pressure and obesity can precipitate this.

Affecting more than 300,000 Brits, untreated aortic valve stenosis can lead to a number of serious conditions, including heart failure.

For most patients, the only effective option is to replace the defective valve, and in the past this was done with open heart surgery, a major surgery that involves making a deep incision in the chest to reach the heart.

While this procedure is almost always safe and effective, there are risks of life-threatening complications during surgery from general anesthesia, infection, or heart failure.

It may also take several weeks or even months for patients to fully recover.

For these reasons, patients with aortic valve stenosis who are thought to be very old or frail are told that they cannot have open heart surgery.

More than 50,000 Brits fall into this category, according to a study from the University of Notre Dame in Australia that looked at UK health data.

First performed on the NHS in 2007, TAVI requires only a small incision, usually in the groin. A catheter is inserted and screwed into the heart.

This tube carries an artificial valve around a deflated balloon, usually made from animal heart tissue from a cow or pig. Once the catheter reaches the defective part, the balloon is inflated and expanded until the artificial valve locks into place.

The technique has been shown in numerous studies to be both safe and highly effective.

Patients, on average, spend significantly less recovery time and are less likely to experience complications than those undergoing open heart surgery in the hospital. But experts warn that those who need intervention may not get it.

“As a result, there is very little TAVI in the NHS and it is costing lives,” said Dr Daniel Blackman, cardiologist at Leeds Teaching Hospitals NHS Trust. “Unfortunately, patients waiting for the procedure die every month across the country.”

Affecting more than 300,000 Brits, untreated aortic valve stenosis can lead to a number of serious conditions, including heart failure. (Image file)

Dr. The problem is that hospitals have limited resources, says Blackman, who runs a TAVI clinic in Leeds and teaches other doctors how to do the procedure.

“We do TAVI three days a week and we can do four or even five,” he says. ‘We need additional resources like more hospital space and more funding. Almost all centers offering TAVI are in the same location.’

Heart charities say hospital administrators are reluctant to invest more money in the procedure because it is more expensive than open-heart surgery.

“Hospital administrators are looking at the cost of the device rather than the implied cost,” said Wil Woan, CEO of the Heart Valve Voice charity.

“Yes, it’s more expensive than open heart surgery but that doesn’t take into account the money that will ultimately be saved by keeping these patients out of the hospital, not to mention that TAVI patients have less time to recuperate on the ward, freeing up more critical bed space.

Patient John Morrison died at the age of 69 after waiting two years for TAVI. The County Armagh Gaelic football manager was diagnosed with aortic valve stenosis in 2016.

According to her 43-year-old daughter, Kate Haffey, doctors initially told her there was nothing to be afraid of.

Since John had a quadruple bypass 20 years ago, doctors thought open heart surgery was too risky. Instead he was told he would get a TAVI.

“The doctors said that if she had taken TAVI she could have avoided an invasive procedure and that would mean a speedy recovery,” says Kate.

But in 2018, John still didn’t have a date for the procedure, and his health began to deteriorate.

“Her breathing got so bad she could barely walk,” said the mother of three Kates, a rescuer. “We kept calling her counselor to say we were worried, but they still couldn’t tell when she was going to have surgery.”

Kate says the hospital told her father there was no room for her on the ward. However, 50 days before his death in February 2019, he was hospitalized five times due to heart problems.

Kate says: “A week before her death, her counselor said she was going on vacation and that Dad would get his TAVI when he got back.”

An autopsy found that John died of arrhythmia — an abnormal heart rhythm — caused by aortic valve stenosis.

“My father died knowing that rescuing him would require a procedure, and he didn’t understand it,” says Kate.