A life-saving procedure to repair ‘leaky’ valves within the heart is now going to be available to NHS patients across the UK. It’s called Trans-catheter Edge to Edge Repair (TEER) and is performed via keyhole surgery.
Doctors access the mitral valve (located in the inner chambers of the heart) with a catheter guided through a vein in the patient’s groin. One or more small, implanted clips are attached to the mitral valve, closing off the leak and restoring normal blood flow. The two-hour procedure is a less invasive alternative to open heart surgery, with patients up and about the next day, and home soon after.
Professor Dan Blackman, Interventional Cardiologist at Leeds Teaching Hospitals NHS Trust and Director of the UK Valve for Life programme, said: “It is hugely exciting that TEER is now available across the NHS. This decision comes after a funding battle which has taken more than 10 years since the initial NHS decision not to fund in 2011. It follows a two-year evaluation to prove its effectiveness, and further delays due to the COVID-19 pandemic in more recent years. This is a life changing and life-saving procedure.”
Most patients experience substantial improvements in symptoms and quality of life following the TEER procedure, such as a marked reduction in breathlessness, with the ability to perform everyday tasks such as walking up a flight of stairs, doing housework or simply taking a short walk restored.
“One of the most dramatic results I have seen was a patient who was in hospital for 11 weeks, and was stuck on the intensive care unit, critically ill. After we performed TEER he was discharged from hospital in just a week. This was a remarkable outcome and highlights just how effective this straightforward procedure can be,” adds Professor Blackman.
His patient was Michael Thompson, 72, a father of two and retired Sales Director from Rawdon, Leeds.
He said: “At 68 I was fit for my age, I played golf three times a week and went to the gym, but then I suddenly felt out of breath, and I deteriorated rapidly – within a month I couldn’t walk 20 feet - and I was in hospital on oxygen for 11 weeks. Things got worse; I developed blood clots on my lungs, I was retaining fluid all over my body – oedema – and I was at high risk for kidney and liver failure. I was too weak for open heart surgery, but fortunately at my hospital they did the mitral clip procedure and Dr Dan Blackman did mine.
“The recovery was amazingly quick. Within a week the oedema was gone, and I was discharged to a recovery unit for physio and four weeks later I was home. When I was assessed for home help the man joked ‘where’s the chap who’s poorly?’ because I was already so well. Incredibly, I was back on the golf course a month later! It’s brilliant that mitral clip (TEER) will be available across the NHS.”
Delays in NHS funding have left the UK lagging behind its European neighbours in access to the TEER procedure. Recent data showed that in Germany 50x more procedures were performed annually, while Switzerland completed 30x more, with the UK at the bottom of a league table of Western European nations.
It is expected that with 20 active centres the UK will be able to achieve similar procedure rates to other European countries. Each centre could perform up to 50 procedures each year based on capacity. It is possible that hundreds of mitral clips will be fitted by the end of the year because of the new care pathway.
