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Disease insight reports

Improving care pathways

As in so many areas of healthcare, increased demand for TAVI procedures for patients with severe aortic stenosis (AS) has not been matched with a proportional increase in available resources in recent years. This whitepaper captures the findings of a recent advisory board meeting which explored the opportunity to increase the capacity for TAVI procedures within the NHS through truly integrated care and improved referral pathways.

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Increasing numbers of patients with AS are waiting for TAVI in the UK and this situation will have worsened after the COVID-19 pandemic. A number of these patients will require pacing, but different centres across the UK have different approaches in terms of patient management and technology choices, and there is significant variation in the rate of post-TAVI PPI across centres. A unified strategy is required to ensure that patients receive a consistent level of care, with the aim of reducing waiting times to access TAVI, reducing PPI where possible and optimising patient outcomes.

PPI post-TAVI increases the hospital mean length of stay (LOS), which presents a capacity issue, especially in light of the COVID-19 pandemic, so it is important that a clearly defined and integrated ‘best practice TAVI pathway’ is developed with a standardised protocol for PPI embedded within it.

This advisory board meeting highlighted that there is much scope to increase the capacity for TAVI procedures within the NHS by the introduction of true integrated care, which could improve the referral pathway for patients and increase the efficiency of tertiary centre multidisciplinary teams.

View our interview with Dr Clare Appleby, consultant cardiologist at the Liverpool Heart and Chest Hospital

Our healthcare consultant Sarah Shield talks to Dr Appleby about some of the issues raised in the whitepaper, particularly around the increased demand, pressures on capacity and the need to triage and manage patients that may require pacing.