Pavilion Health Today
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Thousands of mitral regurgitation patients missing out on life-saving procedure

A life-saving medical procedure called Trans-catheter Edge-to-edge Repair (or TEER) is not available to many mitral regurgitation patients it could help.

Thousands of people with mitral regurgitation have been excluded from a life-saving medical procedure due to a current gap in commissioning.

The procedure is called Trans-catheter Edge-to-edge Repair (or TEER) and it is a simpler and safer solution than open heart surgery for mitral regurgitation patients, but terminology on the current NHS paperwork means it is only commissioned for patients with degenerative mitral regurgitation, which occurs when ‘wear and tear’ or a floppy mitral valve causes a severe leak. Patients with functional mitral regurgitation, which often occurs after a heart attack, or when the heart pump is weak (heart failure), are currently excluded.

The UK Valve for Life initiative, which aims to improve and expand access to life-saving and life-changing minimally invasive ‘key-hole’ therapies for heart valve disease, is now urging the NHS to update the small print. It says a severely leaky mitral valve, if left untreated, can be deadly or cause severe heart failure.

Some mitral regurgitation patients waiting for treatment in intensive care

Dr Jonathan Byrne, UK Lead of the Valve for Life Programme and Consultant Cardiologist at King’s College London, said: “There was a 10-year funding battle to have TEER commissioned by the NHS in the first place but it has excluded a large number of patients who can benefit for this treatment. The British Cardiovascular Intervention Society (BCIS) and Valve for Life have been campaigning for almost two years to ensure that suitable patients with mitral regurgitation have access to treatment.

“Although it sounds simple terminology, or medical wording it means that a large number of patients are excluded from this routine, safe and effective treatment. They continue to struggle on with symptoms and will need to see their GPs frequently for support. Many are readmitted to hospitals and may be in and out of A&E with problems. In extreme cases, some patients who have suffered a large heart attack can languish on Intensive Care Units, waiting for treatment. Open heart surgery is not usually an option for these patients.  It is very frustrating as a clinician because TEER is really very straightforward, even for a patient who is very unwell.”

TEER is performed via keyhole surgery and takes less than two hours. A catheter is guided through a vein in the patient’s groin up to the heart and there one or more implanted ‘clips’ are attached to the mitral valve, which is located in the inner chambers of the heart. This stops the leak and restores normal heart function. The majority of patients are mobile within a day and can leave hospital shortly after.

Even gravely ill patients experience significant improvements in their symptoms and quality of life following the TEER procedure, such as dramatic improvements in their breathlessness and their ability to perform everyday tasks such as walking up a flight of stairs, doing housework or simply taking a short walk.

author avatar
Alison Bloomer
Alison Bloomer is Editor of Pavilion Health Today. She has over 25 years of experience writing for medical journals and trade publications. Subjects include healthcare, pharmaceuticals, disability, insurance, stock market and emerging technologies.

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