Assurances for improvements in cardiac care given to Health Board chiefs

ASSURANCES about improvements in cardiac care have been given to Swansea Bay health board chiefs following a critical review.

Board members were told that processes have been tightened up for elderly cardiac patients who are eligible for a procedure called a trans-catheter aortic valve implantation (Tavi), which is much less invasive than open heart surgery.

Experts from the Royal College of Physicians (RCP) had made a series of recommendations after being called in by the health board to assess the clinical management of elderly patients at Morriston Hospital between 2015 and 2018.

The RCP found that the care of 23 of 32 of these patients who died after being assessed for a Tavi procedure was unsatisfactory.

All patients with a moderate to severe narrowing of the aortic valve who are deemed high risk for surgery are now seen by a cardiologist and a cardiac surgeon at the same time to assess whether they’re better off having a Tavi procedure or a replacement valve.

This joint clinic has been suspended since March due to the cornavirus pandemic, but patients are still being seen and treated, with many undergoing the Tavi procedure.

A health board report said waiting times for some patients have lengthened since Covid-19 – partly because demand has increased – but that the backlog of cases was being addressed. Only two out of 49 patients on the Tavi list had been waiting more than 26 weeks, but one was due to have the procedure within five days, while the other was deciding whether they wanted to go ahead with it.

The report added that no patients have died while waiting for a Tavi procedure since May last year.

Speaking at a health board meeting on September 24, executive medical director Richard Evans said internal measures had been introduced as well as the RCP recommendations.

He added: “While Covid has presented challenges for us with Tavi, the update that is provided will hopefully provide the board with assurances in terms of the tightening up of processes within that service.”

Associate board member, Andrew Jarrett, thanked Mr Evans and his team for their efforts.

Extra money and staff resources have been directed at Tavi cases.

“As a board member I feel much more confident now than I have in the past,” said Mr Jarrett.

When the RCP’s review was first discussed in April this year, the health board apologised unreservedly to patients and their families affected by past delays.