UHCW Valve Team Newsletter by

Introduction

UHCWheartvalveteam — 2023-05-09 06:19:57 UTC

Welcome to our new Valve Team Newsletter. The aim is to keep you updated with what’s happening locally at UHCW, and if there are any national updates.

If you have any stories you would like to share, please get in touch via AorticValveService@uhcw.nhs.uk.

Please also let us know if there is any specific information you would like updates on.

TAVI cases 2023

UHCWheartvalveteam — 2023-05-09 06:21:39 UTC

From Jan 1st to December 31st we have performed 155 TAVI procedures.

35% were inpatients or transfers from other hospitals.

The median wait for electives (referral to treatment) was 5 months, which compares favourably to the regional median wait. Capacity has been increased in 2024 to improve this further.

4 of our patients that had critical Aortic Stenosis underwent CT, Clinic appointment and TAVI in less than 3 weeks. If you are concerned about a particular patient, please get in touch with us so that we can escalate their procedure.

The Launch of TEER

UHCWheartvalveteam — 2023-05-09 06:22:17 UTC

In March 2023 we performed our first ever Transcatheter Edge to Edge Repair (TEER) procedure. This is offered to patients with severe Mitral Regurgitation, who have been deemed too high risk for surgical intervention. We now run a specific Mitral Valve MDT once a month where all patients are discussed.

Trip to Parliament

UHCWheartvalveteam — 2023-05-09 06:29:27 UTC

In 2023 our Heart Valve Clinical Nurse Specialist, Lauren Deegan was approached to join a group of experts in the field of Heart Valve Disease.

Meetings were held to discuss the health gender gap for treating Aortic Stenosis (which is not only an issue in the UK but globally). It has been found that if you are a woman with severe Aortic Stenosis, you are less likely to get treatment, compared to a man. (https://openheart.bmj.com/content/10/2/e002373)

As a group they looked at the barriers to diagnosis and treatment, faced by patients and healthcare professionals.

At the end of April 2023, Solutions were presented to MPs via the All Party Parliamentary Group for Women’s Health, and a Call to Action was raised for the government to implement the solutions.

Referral advice

UHCWheartvalveteam — 2023-05-09 06:36:29 UTC

Referring for TAVI?
Please include:
- Current symptoms
- PMH
- Clinical fraility score to assist with MDT discussions
- Attach echo report (and send CD if not using PACS)
- Angiogram not required unless the patient has angina
- Lung Function not required as local anaestetic used

TAVI Team Useful Contacts

UHCWheartvalveteam — 2023-05-09 06:36:45 UTC

AorticValveService@uhcw.nhs.uk

Structural Heart Clinical Nurse Specialists:

Lauren Deegan

02476 965785 or lauren.deegan@uhcw.nhs.uk

Joanne Keane

02476 965785 or Joanne.Keane2@uhcw.nhs.uk

Secretary Julie Jupp: 02476 965670

Cardiology Consultants (TAVI operators):

Dr T. Rajathurai: 02476 965003

thirumaran.rajathurai@uhcw.nhs.uk

Dr L. Tapp: 02476 965703

luke.tapp@uhcw.nhs.uk

Dr N. Gangil: 02476 965713

nishant.gangil@uhcw.nhs.uk

Cardiology Consultant (Imaging)

Dr J. Khan: 02476 965670

jamal.khan@uhcw.nhs.uk

New NHS England Guidance

UHCWheartvalveteam — 2023-05-09 06:38:17 UTC

Have you seen the new guidance?

In February 2023, NHS England stated that we can now offer TAVI to patients with intermediate AND low surgical risk. This interim position aims to alleviate the pressures on local systems in supporting elective performance and is dependent on the ability and capacity of systems to deliver either option.

Cardiothoracic Useful Contacts

UHCWheartvalveteam — 2023-05-22 18:12:17 UTC

Secretary Yvonne Tennant: 02476 965678

Cardiothoracic Liaison Nurses: 02476 965803

cardiacliaisonteam@uhcw.nhs.uk

Cardiothoracic Surgeons:

Mr Uday Dandekar:

uday.dandekar@uhcw.nhs.uk

Mr Thomas Barker:

thomas.barker@uhcw.nhs.uk

Mr Sendhil Balasubramanian: sendhilK.Balasubramanian@uhcw.nhs.uk

Mr Massimiliano Codispoti:

massimiliano.codispoti@uhcw.nhs.uk

Mr Jain Bhaskara-Pillai:

Jain.BhaskaraPillai@uhcw.nhs.uk

Interesting Case - 81-year-old man with breathlessness and angina. PMH of triple-vessel CABG plus St Jude Epic 21 mm bioprosthetic aortic valve replacement (AVR) surgery 7 years prior.

UHCWheartvalveteam — 2023-05-23 16:19:25 UTC

Imaging of prosthetic cardiac valves using echocardiography can be significantly limited by reverberation and shielding artefacts, degrading leaflet assessment.
Degenerative calcification, pannus and thrombus are key differentials for bioprosthetic valve obstruction and can be challenging to assess on echocardiography, X-ray fluoroscopy and cardiovascular MRI.
Cardiac CT allows accurate non-invasive assessment of prosthetic valves with high spatial resolution. It allows excellent assessment of leaflet mobility, assessment for calcification, pannus and thrombus, visualisation of complications arising from endocarditis (abscesses, dehiscence) and also permits left ventricular and coronary artery assessment within the same study.

UHCW Aortic programme - managing patients with diseases of the thoracic aorta

UHCWheartvalveteam — 2024-01-08 17:45:23 UTC

The aortic programme at UHCW NHS Trust, manages patients with diseases of the thoracic aorta, providing comprehensive care for patients with complex aortic disease. It treats patients with aortic valve disease, aortic root affection, ascending aortic and arch aneurysms. In collaboration with our vascular surgeons, we are also involved in treating patient with proximal descending aortic pathology. Besides elective aortic work, the unit caters to acute aortic pathology which involves treating acute Type ‘A’ dissections. The team provides 24-hour service in managing acute aortic pathology, click on the picture to find out more.