The National Institute for Health and Care Excellence (Nice ) has approved a minimally invasive heart valve repairing procedure for NHS patients who would not be able to have conventional open-heart surgery.
Until now, patients who required mitral valve repair only had the option of open-heart surgery but for some older and more frail patients, this is considered too risky. These patients are set to benefit from NICE approving the less invasive valve repairing method in draft recommendations. The institute has recommended that the procedure be widely available across NHS England.
The new method involves a surgeon using ultrasound to pass a stainless steel clip through a vein in the groin into the mitral valve inside the heart while the patient is under general anaesthesia.
The clip attaches to the flaps of the mitral valve and helps it close more completely. After this procedure, patients are normally sent home after a one-night stay in hospital.
NICE added that only patients who are too high-risk for open-heart surgery should be considered for this procedure and it must only be carried out by an experienced team of clinicians in specialist centres. It also stated that data must be collected from every procedure in the National Institute for Cardiovascular Outcomes Research database.
NICE programme director and clinical advisor for the Interventional Procedures Programme Professor Kevin Harris said: “This innovative procedure can reduce the symptoms of heart failure and improve quality of life.
“The latest evidence was reviewed by a NICE committee which concluded that the procedure worked well enough and was safe enough to be offered to those too old or too sick to have their mitral valve repaired through open-heart surgery.
“The procedure has the potential to improve their symptoms and to extend their lives.”
British Cardiovascular Intervention Society secretary Dr Dan Blackman said: “This NICE guidance will be warmly welcomed by patients and specialists.
“Mitral regurgitation causes breathlessness, hospitalisation and reduces life expectancy. Unfortunately many patients are not fit enough to undergo open-heart surgery, and until now these patients have had no effective alternative treatment.
“Percutaneous mitral valve leaflet repair represents an excellent option for this patient group. Recent data have shown this technique offers major benefits in symptom relief, improved quality of life, and reduced hospitalisation.
“We hope that the endorsement of the procedure by NICE will soon lead to it being routinely available across the NHS.”
Interventional Procedures guidance is not compulsory and commissioners still need to decide whether to routinely fund this procedure. Consultation on this procedure is now open and any draft recommendation comments can be made until January 2019.