New research from team including University of Leeds professor warns heart surgery delays will cost lives

The researchers, including Chris Gale, a Professor of Cardiovascular Medicine and Co-Director of the Leeds Institute for Data Analytics at the School of Medicine in the University of Leeds, have warned that a lack of action could result in thousands of people dying while waiting for treatment.

The Covid-19 pandemic has led to thousands of heart procedures being postponed and record waiting lists.

Previous work has estimated that 4,989 people in England with severe aortic stenosis missed out on life saving treatment between March and November 2020.

Aortic stenosis develops when the heart’s aortic valve becomes narrowed, restricting blood flow out of the heart. Prompt treatment is vital for people diagnosed with severe aortic stenosis, as around 50 per cent will die within two years of symptoms beginning.

Now, an international team of researchers supported by the British Heart Foundation has modelled the impact that increasing treatment capacity and using a quicker, less invasive treatment option called transcatheter aortic valve implantation (TAVI) would have on waiting lists.

Even in the best-case scenario, researchers found that the waiting list would take nearly a year to clear and over 700 people would die while waiting for treatment.

The study has been published in the in BMJ Open.

Professor Chris Gale said: “During the COVID-19 pandemic, there was a great decline in procedures used to treat severe aortic stenosis.

“In our study, we found that without a combination of increased capacity for treatment of patients with severe AS and an expansion in the use of TAVI, there would be many potentially avoidable deaths during the post-COVID-19 recovery period.

“This is the only option that will prevent the death of thousands of people who have untreated aortic stenosis.”

The traditional treatment for aortic stenosis involves replacing the narrowed valve, most commonly through open heart surgery (a surgical aortic valve replacement, SAVR).

However, TAVI, which is a newer keyhole procedure, 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.

This research was part funded by the EPSRC Cambridge Centre for Mathematics of Information in Healthcare.