Cardiac specialists are calling on the Scottish Government to give the green light to a heart valve replacement procedure they say would transform the lives of over one hundred patients every year.
Clinicians in England are being told today by the health assessment body NICE that Transcatheter Aortic Valve Implantation (TAVI) can now be regarded as being under “normal arrangements for clinical governance” for patients where traditional open heart surgery to replace faulty valves would be too risky. TAVI has been available for selected patients across England, Wales and Northern Ireland for the past four years.
Many patients have already been identified by the cardiothoracic centres in Scotland as suitable for TAVI but very few have undergone the procedure and they have all had to travel to centres in England or Northern Ireland. The Scottish Government had told MSPs that they would await today’s NICE report before making a decision on allowing the procedure to be carried out in Scotland.
Scotland’s track record in adopting innovative technologies in the area of heart disease is poor.
Clinical Director for Cardiac Services at the Royal Infirmary of Edinburgh, Dr Neal Uren, says he hopes this leaves the way open for TAVI to be offered to Scottish patients in Scotland.
He said: “This is a specialist alternative to surgical valve replacement for people whose aortic heart valve becomes increasingly narrowed, a condition known as aortic stenosis. TAVI is a proven technology giving normal lives back to the people who receive it. There is now very good evidence that it is cost-effective in a carefully selected high-risk population of older people that NICE has been looking at who have been turned down for the traditional surgical approach is too dangerous. NICE examined the procedure in considerable detail and has recommended that cardiologists in England should go ahead and offer TAVI in all suitable cases. We sincerely hope that this will persuade the NHS in Scotland to let us get on and do the same for Scottish patients.”
Professor Keith Oldroyd, a Consultant Cardiologist in Glasgow says Scottish centres are several years behind their counterparts in England:
“Scotland’s track record in adopting innovative technologies in the area of heart disease is poor and needs to be improved. Even a country like Greece with its dire economic situation has initiated a TAVI programme. Across Scotland right now there are around 100 patients who have been deemed suitable for the TAVI procedure, many of whom have been referred by heart surgeons reluctant to perform conventional open heart surgery. Now that English patients in this high risk group will be eligible for it automatically, I cannot see anything in the way of the Scottish Government allowing TAVI to be performed in Scotland”
Mrs Christina Fyvie (75) lives in Paisley and has been told TAVI would be the only option for her aortic stenosis as it is too dangerous to repair her aortic valve using conventional surgery:
“I feel breathless all the time and walking is a struggle. I can only get out using a wheelchair with my husband helping me. I am pleased for patients in England but also quite angry that I cannot get TAVI because I live here. It seems very strange to me that we have the skills in Scotland to do this but it’s not being allowed. I hope Nicola Sturgeon will now act to end this cross border divide.”
Mrs Violet Buyers, (85), lives in the Saughton area of Edinburgh and was told four years ago that open-heart surgery was too risky to replace her aortic heart valve and that she would be in line to be one of the first to have TAVI when it became available.
“It seems unfair that if I was living in England I would be almost guaranteed to get the treatment that my specialists tell me would make a big difference,” says Mrs Buyers.
“At the moment I am confined to the house and can only take short trips out if someone can give me a lift from door to door as I can’t walk far at all. My doctors are all very apologetic saying they know there is a treatment that will make me much better but they can’t give it to me.”
