Heart surgery delays will cost lives, warns research

Urgent action is needed to clear the backlog of people with a common heart condition who are waiting for lifesaving treatment, according to research supported by the British Heart Foundation published today in BMJ Open^. The researchers have warned that a lack of action could result in thousands of people dying while waiting for treatment.

This follows the “Modelling Solutions to the Impact of COVID-19 on Cardiovascular Waiting Lists” Virtual Study Group which took place in February 2021. This was developed and delivered by the Gateway on behalf of V-KEMS and explored the challenges related to the delays in seeking and gaining access to cardiovascular treatments caused by the COVID-19 pandemic and the impact this will have upon waiting lists. Following the event, clinicians and modellers have continued to work together and the Gateway is proud to have instigated this collaboration.
 
Now, an international team of researchers has modelled the impact that increasing treatment capacity and using a quicker, less invasive treatment option would have on waiting lists. Even in the best-case scenario, they found that the waiting list would take nearly a year to clear and over 700 people would die while waiting for treatment.

The traditional treatment for aortic stenosis involves replacing the narrowed valve, most commonly through open heart surgery (a surgical aortic valve replacement, SAVR). However, a newer keyhole procedure called a transcatheter aortic valve implantation (TAVI) is increasingly being used and is now recommended for patients aged 75 and over.

The researchers investigated the impact that increasing treatment capacity and converting a proportion of operations to the quicker TAVI procedure would have on the backlog. They looked at how long it would take to clear the backlog and the number of people who would die while waiting for treatment.
They found that the best and most achievable option involved a combination of increasing capacity by 20 per cent and converting 40 per cent of procedures from SAVR to TAVI. This would clear the backlog within 343 days with 784 deaths while people wait for treatment.

The team say they want to see greater collaboration at local and national levels to agree the changes needed that can ensure that people with severe aortic stenosis receive lifesaving treatment as quickly as possible.

The research was funded by EPSRC Cambridge Centre for Mathematics of Information in Healthcare. The Gateway facilitated initial interactions as well as contributing to other ongoing activities linked to the Study Group.

More details about the event that led to the publishing of the paper can be read here as well as a  working paper which was published after the event.
A podcast by Plus Magazine about the event is available as well as a Case Study.