Heart experts at The James Cook University Hospital have doubled their use of a leading-edge minimally invasive heart valve replacement procedure and are now helping other teams across the UK to streamline their programmes.
Cardiology teams looking to optimise transcatheter aortic valve implantation (TAVI) programmes can now access detailed guidance based on best practice from the Middlesbrough team who have more than doubled TAVI procedures over the last five years.
TAVI is an advanced procedure in which a team of specially trained consultants replace narrowed heart valves without the need for open heart surgery. It is a much less invasive treatment, where patients are fitted with new heart valves through a small cut in their groin or chest.
The James Cook team have been carrying out TAVI procedures since November 2009 and have developed a clear understanding of patients who can benefit from the procedure and how best to manage their patient journey.
Consultant cardiologist Douglas Muir said: “Our integrated aortic valve pathway ensures patients get the right treatment, in the right place, at the right time, while also helping us to provide a more efficient service by reducing cancellations and getting patients home faster.
“In 2017-18, before the COVID-19 pandemic, we performed 106 TAVI cases, last year this increased to 236.”
The team have also introduced a day case programme for selected patients – one of the first in the world.
Consultant cardiologist Paul Williams said: “TAVI dramatically cuts the length of recovery – our patients are typically up and about within a few hours and up to a quarter of cases now go home the same day.”
Getting It Right First Time
Getting It Right First Time (GIRFT) worked with the team to produce the delivery guide so other clinicians across the UK can share their successes, including:
- Integrating a specialist nurse as a single point of contact for patients and referring teams
- Careful patient selection and assessment using a pre-admission clinic
- Establishing an effective multidisciplinary TAVI team
- Developing documents on how to support and care for patients before and after their procedures
Consultant cardiologist Seth Vijayan said: “We have now performed approximately 2,000 TAVI procedures and it is fantastic to be able to share our experience and knowledge to benefit patients right across the country.”
Specialist nurse Gemma McCalmont added: “We have recognised the importance of a focussed approach to how we deliver care from referral to discharge.
“The delivery guide highlights the importance of doctors, nurses and other health professionals working together to improve outcomes for patients.”