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IMPORTANT NEWS ABOUT TAVI
Newly announced Medicare rebate for TAVI heralds broader access for Australians with aortic stenosis
In November this year, the minimally invasive Transcatheter Aortic Valve Implantation (TAVI) procedure was given a Medicare Benefits Scheme (MBS) item number, making the treatment more accessible for suitable patients.
TAVI has revolutionised the treatment of heart disease by enabling the keyhole replacement of the aortic valve without the need for open heart surgery.
The procedure is fast becoming the treatment of choice for aortic stenosis, particularly in older patients or those with complex medical conditions who might be at higher risk from surgical valve replacement.
Aortic stenosis is the most common form of valvular heart disease, especially in older patients where it affects about 1 in 10 Australians over the age of 75.
Dr Jason Kaplan, Head of the Cardiovascular and Respiratory Program at Macquarie University Hospital, said that the formal MBS item number for TAVI and re-imbursement for the prosthesis significantly reduces the cost previously associated with the procedure, providing equitable access to this technology.
“This is a proven alternative to surgery that is especially beneficial for older patients and those with multiple other medical problems,” said Dr Kaplan. “More than ten years of robust data now demonstrates TAVI is as effective as traditional open surgical valve replacement for appropriate patients.
“Our TAVI program has been in place for several years. Patients choosing Macquarie University Hospital for this procedure enter a well-established program, with balanced multidisciplinary team assessment, and cardiologists and cardiothoracic surgeons who are the most experienced in this procedure in Australia.”
The Hospital’s TAVI team is unique in NSW with every procedure being attended by an interventional cardiologist and cardiothoracic surgeon. This provides a high level of care and expertise to perform the procedure safely.
Interventional cardiologist Professor Martin Ng and cardiothoracic surgeon Michael Wilson perform about 60 TAVI procedures annually as a team at Macquarie University Hospital – well over 100 per year overall, when factoring in their cases at Royal Prince Alfred Hospital. This makes the Macquarie University Hospital TAVI team one of the highest volume TAVI proceduralists in the Southern Hemisphere.
“With TAVI, there is a clear volume-outcome relationship that is well-demonstrated in the literature,” said Professor Ng, who is actively engaged in TAVI clinical trials and has published extensively on the procedure and patient outcomes.
“Macquarie University Hospital currently has the largest TAVI program across the private hospital sector in Ausralia, with our data showing that we achieve better patient outcomes than in other international registries.”
The TAVI team at Macquarie University Hospital is also innovative. It was the first to use TAVI in congenital heart disease and in conjunction with by-pass surgery, and has developed approaches using alternative access routes where the femoral artery is not viable.
“TAVI is the lead program in Macquarie University Hospital’s Structural Heart Program with a multidisciplinary clinic offering a comprehensive range of procedures from minimally invasive surgery, TAVI and Mitraclip to Robotic Mitral Valve Repairs,” said Professor Wilson, a leading Sydney surgeon and pioneer in off-pump coronary artery by-pass graft surgery.
TRANSCATHETER AORTIC VALVE IMPLANTATION
Macquarie University Hospital was the first private hospital in New South Wales to conduct Transcatheter Aortic Valve Implantation (TAVI), and the first in the southern hemisphere to offer a full TAVI Program to support patients undergoing the procedure. It is now the busiest TAVI centre in New South Wales and its surgeons are the most experienced in delivering advanced surgical procedures. The Hospital has invested significantly in the Program, which is a robust, comprehensive, diagnostic, surgical and recovery service getting outstanding results for patients.The TAVI Program at MUH has one of the most experienced structural heart teams. The surgeons use the Hospital's state-of-the-art hybrid operating suite for both traditional and minimally invasive procedures. Surgeons perform a unique combination of procedures tailored to an individual patient's condition. The Hospital also offers an excellent ICU and other post surgery support services. To find out more click here
The TAVI Clinic:
Currently, Macquarie University Hospital has the only TAVI Clinic in Australia. The Clinic brings together all TAVI specialists under the one roof. Patients are assessed at the same time by a range of specialists, saving time and reducing stress for elderly or very sick patients. Importantly, in addition to being reviewed by a Clinical Nurse Manager, each patient is seen by both a cardiologist and cardiothoracic surgeon, receiving a balanced view of their case and the best possible treatment options.
Geriatricians, physiotherapists, intensive care specialists, anaesthetists and other support staff also become part of a patient’s multidisciplinary team once they proceed to surgery. All services are available to our patients in the single Hospital location, making the experience as convenient and seamless as possible.
Macquarie University Hospital’s TAVI Program Features:
First comprehensive TAVI program in the Southern Hemisphere
Multidisciplinary team (MDT) approach allowing comprehensive review and ongoing care
One of the most experienced structural heart teams, having done more than 300 TAVI procedures to date
Hybrid Operating Suite for both traditional and minimally invasive procedures
Ability to perform unique combinations of procedures tailored to an individual patient’s condition
Outstanding results, with 93 per cent of TAVI patients alive and independent after 12 months
Outstanding ICU and other post-surgery support services.
The TAVI Program has established a streamlined model of care, under one roof, that reduces stress and anxiety for patients and their families. Patients are assessed by a range of specialists in one location, saving time. In additional to being reviewed by a structural heart nurse, each patient is seen by a cardiology and cardiothoracic surgeon, offering the patient a balanced view of their case and the best possible treatment option. The Program also offers family and patient education and comprehensive discharge plans.
Multidisciplinary Team Approach
Regular multidisciplinary team (MDT) meetings are a vital part of the success of the TAVI program. Surgeons, geriatricians, physiotherapists, intensive care specialists and other support staff form part of the MDT. Every TAVI patient is discussed by the MDT at a monthly meeting. The MDT approach allows comprehensive review and ongoing care for patients. Macquarie University Hospital was the first private hospital in New South Wales to conduct Transcatheter Aortic Valve Implantation, or TAVI, and the first in the southern hemisphere to offer a full TAVI program to support patients undergoing the procedure.
Today, the Hospital’s TAVI program remains a robust and comprehensive diagnostic, surgical and recovery service, with the team getting outstanding long-term results. The minimally invasive TAVI procedure is of particular benefit in treating aortic valve disease in the elderly and other high-risk populations for whom conventional surgery is not an option. To be fully effective, TAVI requires a multidisciplinary and cohesive heart team to be in place.
Macquarie University Hospital offers the procedure to suitable patients through its Heart Care Centre. The centre has a large team of diagnostic cardiologists, interventional cardiologists and cardio thoracic surgeons who, as a diverse group of heart specialists, work collaboratively to determine the best treatment for each individual patient. The TAVI surgical team has access to the advanced imaging capabilities at Macquarie Medical Imaging, and to Macquarie University Hospital’s state-of-the-art Hybrid Theatre, where surgeons can conduct both traditional and minimally invasive surgery.