Background: Valve disease is using up an important, growing proportion of the resources allocated for healthcare. Clinical care is often suboptimal and while multidisciplinary clinics are the 'gold standard', their adoption has been patchy and inhomogeneous.
Methods: We hypothesised that adoption of valve clinics can deliver financial savings and set out to estimate differences in cost between a standard model in which the cardiologist sees every case and a multidisciplinary model in which some cases are devolved to sonographer-led or nurse-led clinics, assuming usage of various tests in accordance with practice at our institutions and to published data. We developed a tool that allows the modelling of limitless permutations in order to assess costs.
Results: Seeing 100 new patients in a valve clinic is more expensive than seeing them in the conventional set-up (excess cost £2700, $4252). Follow-up of both patients with native valve disease (maximal savings/100 patients-£5166, $8135) and with operated valves (maximal savings/100 patients-£5090, $8015) is cheaper in a valve clinic than in a general cardiology clinic and the savings offset the increased cost of seeing new patients in the valve clinic.
Conclusions: The costing implications of valve clinics need to be worked out carefully. Our analysis suggests that important savings in healthcare costs could be achieved by their adoption. Clarifying the economic implications of this new model of care should become one of the priorities for the 'heart valve community'.
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http://dx.doi.org/10.1136/openhrt-2015-000275 | DOI Listing |
Pediatr Cardiol
January 2025
Pediatric Intensive Care Department, Wolfson Medical Center, Holon, Israel.
Research establishing factors associated with duration of mechanical ventilation after Tetralogy of Fallot repair, is mainly based on population presenting at early infancy. There are fewer reports regarding repair after infancy, during childhood and preadolescence. To compare two groups of late TOF repair based on post-operative invasive mechanical ventilation duration and explore associations with pre-operative clinical markers of severity of right ventricular outflow tract obstruction.
View Article and Find Full Text PDFJACC Cardiovasc Interv
January 2025
Ascension St Vincent Heart Center of Indiana, Indianapolis, Indiana, USA.
Background: The optimal timing for percutaneous coronary intervention (PCI) in patients undergoing transcatheter aortic valve replacement (TAVR) is debatable.
Objectives: The aim of this study was to compare outcomes based on the timing of PCI in stable coronary artery disease patients undergoing TAVR.
Methods: Leveraging the STS/ACC TVT Registry and Medicare Linkage, we analyzed patients with stable coronary artery disease undergoing PCI and TAVR between 2015 and 2023 using the SAPIEN 3 balloon-expandable valve platform.
Can J Cardiol
January 2025
The Morris Kahn Laboratory of Human Genetics, Faculty of Health Sciences and National Institute of Biotechnology in the Negev, Ben Gurion University of the Negev, Be'er Sheva, Israel; Genetics Institute, Soroka University Medical Center, Be'er Sheva, Israel; The Danek Gertner Institute of Human Genetics, Sheba Medical Center, Ramat Gan, Israel. Electronic address:
Background: Mitral valve prolapse (MVP) is a common cardiac valvular anomaly that can be caused by mutations in genes of various biological pathways. Individuals of three generations of a kindred presented with apparently dominant heredity of isolated MVP.
Methods: Clinical evaluation and echocardiography for all complying family members (n=13).
Ann Thorac Surg
January 2025
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN.
Transcatheter aortic valve-in-valve replacement presents a viable, minimally invasive approach to replacing degraded bioprosthetic surgical valves. The major drawback of this technique is poor hemodynamics in the form of patient-prosthesis mismatch and high transvalvular gradients. This is commonly attributable to the reduced valvular diameter from the transcatheter heart valve fixed inside the degraded bioprosthesis.
View Article and Find Full Text PDFAm Heart J
January 2025
Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
Background: The impact of the COAPT results on clinical practice has not yet been investigated in large real-world cohort study. The aim of the study is to evaluate the potential impact of the COAPT trial by analyzing the temporal trends of baseline characteristics and outcome of secondary mitral regurgitation (SMR) patients undergoing MitraClip (MC) included in the GIOTTO registry.
Methods: The study population was divided into two groups, considering the enrolment before or after the COAPT publication.
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