Non-surgical treatment now available on Medicare
Of the estimated 66,500 Australians living with aortic stenosis, 9 in 10 are not undergoing treatment each year for the potentially life-threatening disease. However, the inclusion of transcatheter aortic valve implantation (TAVI) on Medicare from July 1, 2022, is expanding access to the minimally invasive treatment option for all patients.
Aortic stenosis is a narrowing of the heart valve which makes the heart work harder to pump blood around the body. If not identified, or treated effectively, more than half of those living with severe symptomatic aortic stenosis may die within two years.
According to Dr Ronen Gurvitch, Interventional Cardiologist and TAVI specialist at the Royal Melbourne Hospital, and One Heart Cardiology, Melbourne, aortic stenosis is both under-diagnosed and under-treated in Australia.
“Given aortic stenosis most commonly affects those aged 65 years and over, the symptoms of the disease are often mistakenly confused with the normal signs of ageing, such as gradual reduction in exercise capacity, shortness of breath, fatigue (tiredness) and tightness, or pain in the chest,” said Dr Gurvitch.
“Although a potentially life-threatening disease, aortic stenosis is becoming increasingly treatable, and can be detected by a doctor simply listening to the heart with a stethoscope.
“TAVI is a minimally invasive, non-surgical treatment for aortic valve replacement. The inclusion of TAVI on Medicare for all patients, effectively expands treatment options available to those living with severe aortic stenosis in Australia,” Dr Gurvitch said.
TAVI offers significant benefits over surgery, including reduced procedure time, less time in hospital, a shorter recovery period, lower risk of complications, improved quality of life, and extended life expectancy.
Compared to open heart surgery, the most recent data reveals TAVI results in 46 per cent lower rates of death, stroke and re-hospitalisation within the first year of the procedure.
Brian, 70, Sydney, underwent TAVI for heart valve disease in May 2022, and has already noticed a significant improvement to his daily life.
“Before having TAVI, I was constantly out of breath, and just couldn’t do the things I wanted to. That had a big effect on me, and I had stress and anxiety imagining all the things I wanted to do but couldn’t, because of my heart valve disease,” said Brian.
“I had open heart surgery years ago for another condition, and the difference in recovery between that and the TAVI is night and day. With TAVI, I was home the day after the procedure and noticed an immediate difference – my shortness of breath was gone!
“I’m now able to keep up with my grandkids and finish all the jobs around the house I couldn’t do before. I’m looking forward to finally getting back to doing the things I enjoy doing,” Brian said.
Dr Gurvitch warns that heart valve disease may not initially present with any symptoms.
“Many people living with aortic stenosis may not experience any noticeable symptoms for years until their blood flow is severely restricted. By then, the common symptoms of the disease are often mistakenly attributed to ‘old age’,” said Dr Gurvitch.
“It is therefore, crucial that those living with aortic stenosis are diagnosed early, and receive access to all suitable treatment options.
“The availability of TAVI on Medicare means that all patients with this disease now have access to a minimally invasive, non-surgical approach to aortic valve replacement,”
Dr Gurvitch said.
The rate of severe aortic stenosis is increasing in Australia, with an estimated 10,000 additional people affected each year. A heart murmur is often the first sign of aortic stenosis, and can be detected by a doctor listening to the heart with a stethoscope.
CEO and founder of Hearts4heart, Tanya Hall, Melbourne, has a simple, but crucial message for every Australian aged 65 years and over.
“If you’re aged 65 years and over, ask your doctor to listen to your heart with a stethoscope as part of an annual heart check. It could literally save your life.
“Hearts4heart welcomes the new Medicare item, allowing all patients living with severe aortic stenosis, to access TAVI as a minimally invasive treatment option,” Ms Hall said.
With the number of people living with aortic stenosis in Australia predicted to increase over the next 30 years, particularly among those aged over 75 years, this will place a significant burden on Australia’s healthcare system and economy, given our ageing population. Offering minimally invasive treatments, such as TAVI, to more people aged 65 years and over, could save the public purse AUD 117 million per annum.
Australians aged 65 years and over should ask their doctor to listen to their heart for the signs of aortic stenosis. For information about aortic stenosis and treatment options, such as transcatheter aortic valve implantation (TAVI), head to newheartvalve.com/au.
TAVI is a minimally invasive, non-surgical approach to aortic valve replacement.The procedure is performed by a specially trained interventional cardiologist or cardiothoracic surgeon as part of a Heart Team. The TAVI procedure involves a small incision, usually in the groin, through which a catheter is then inserted into the femoral artery. The artificial heart valve is guided up to the heart, and expanded into place. Importantly, TAVI does not require the removal of the old valve, as it fits within the diseased valve.