Scots denied life-saving heart valve operations

PATIENTS across Scotland are being denied access to a life- saving heart treatment because the NHS refuses to fund the procedure, doctors have warned.

The treatment - known as transcatheter aortic valve implantation (Tavi) - is used to replace a crucial valve in the heart without the need for more invasive surgery.

But doctors in Scotland have been told that they cannot offer the 20,000 procedure, widely available elsewhere in Europe, because of a lack of evidence of its cost-effectiveness.

The Scottish Cardiac Society (SCS) has now written to health secretary, Nicola Sturgeon, to highlight new evidence showing the benefits of Tavi, and calling for equity with the rest of the UK, where patients can benefit from the technique.

Professor Keith Oldroyd, a consultant cardiologist in Glasgow and member of the SCS, said doctors were keen to use the procedure.

"There is nothing more upsetting and frustrating for clinicians than to have the skills to give a patient the treatment they need and be denied the opportunity, particularly when it is widely available everywhere else," he said.

Tavi involves placing a new valve in the heart through a small incision in the groin or chest to help patients suffering from aortic stenosis, which is caused by a narrowing of the aortic valve and leads to symptoms including breathlessness and heart failure.

In March, the Scottish Health Technologies Group, which assesses new technologies for use by the NHS, concluded: "This is currently limited evidence of long-term clinical efficacy, and insufficient information to reliably estimate the cost effectiveness of Tavi."

Two Scottish centres with the expertise to carry out the procedure - Edinburgh Royal Infirmary and the Golden Jubilee National Hospital in Clydebank - have been told they will not be funded to carry it out on patients.

But the SCS has now written to Ms Sturgeon to highlight two major international trials which they say "unequivocally confirmed the efficacy of Tavi as a treatment for severe aortic stenosis".

The cardiologists believe that there are more than 100 patients in Scotland who could benefit from the treatment. Their own research also revealed that around 20 patients had been sent from Scotland to England to have the procedure carried out. Which involves extra travel and accommodation costs

Yesterday Ms Sturgeon signalled that Tavi would be re- examined by experts in Scotland.

"The ongoing success of NHS Scotland in tackling heart disease is reflected in the 59 per cent reduction in premature deaths from the condition over the past 14 years," the minister said.

"The most recent review of Tavi found that there was limited evidence to support its introduction in Scotland."However, I have asked that a further review be undertaken to assess the most up-to-date research."