How to Refer
Referrals to the service can be made by any physician and letters should include:
- Specify symptoms (SOB, angina, syncope)
- Duration / trajectory of symptoms if other reasons for symptoms
- If relevant, trajectory of echo findings, prior gradients, prior LVSD etc
- Medications (especially anti-coagulation, nebs, home O2)
- Comorbidities (prognosis if applicable) – NICE guidelines recommend that TAVI is only performed in patients with an expected survival from non-cardiac disease of greater than 2 years.
- Prior cardiac intervention details (Grafts, PCI, Valve type and size if prior AVR, other valve surgery eg MVR with details)
- Relevant exam findings, especially pulses, BMI if abnormal
- General impression of frailty / tolerability of surgery / TAVI / Details of cognitive function if impaired – MOCA, memory clinic, trajectory). Although TAVI may be considered in patients with mild cognitive dysfunction, current joint society guidelines recommend that TAVI is not performed in patients with an established diagnosis of dementia.
Letters should be posted to the aortic MDT c/o Lindsay Sanderson, Cardiology, The James Cook University Hospital.
If you are referring a patient for inpatient management the above information should be accompanied with a phone call to the team on 07741 616394