Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Cardiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Open Heart. 2021 Mar;8(1). doi: 10.1136/openhrt-2020-001547.
Transcatheter aortic valve implantation (TAVI) is a proven treatment for life-threatening aortic valve disease, predominantly severe aortic stenosis. However, even among developed nations, access to TAVI is not uniform. The Valve for Life initiative was launched by the European Association of Percutaneous Cardiovascular Interventions in 2015 with the objective of improving access to transcatheter valve interventions across Europe. The UK has been identified as a country with low penetration of these procedures and has been selected as the fourth nation to be included in the initiative. Specifically, the number of TAVI procedures carried out in the UK is significantly lower than almost all other European nations. Furthermore, there is substantial geographical inequity in access to TAVI within the UK. As a consequence of this underprovision, waiting times for TAVI are long, and mortality among those waiting intervention is significant. This article reviews these issues, reports new data on access to TAVI in the UK and presents the proposals of the UK Valve for Life team to address the current problems in association with the British Cardiovascular Intervention Society.
经导管主动脉瓣植入术（TAVI）是治疗危及生命的主动脉瓣疾病的有效方法，主要用于治疗严重的主动脉瓣狭窄。然而，即使在发达国家，TAVI 的应用也并不均衡。欧洲经皮心血管介入协会于 2015 年发起了“Valve for Life”倡议，旨在改善欧洲各地经导管瓣膜介入治疗的可及性。英国被认为是这些手术普及率较低的国家之一，并被选为该倡议的第四个参与国。具体来说，在英国开展的 TAVI 手术数量明显低于几乎所有其他欧洲国家。此外，在英国，TAVI 的应用也存在着显著的地域不平等。由于这种服务提供不足，TAVI 的等待时间较长，等待介入治疗的患者死亡率较高。本文综述了这些问题，报告了英国 TAVI 应用的新数据，并介绍了英国“Valve for Life”团队为解决与英国心血管介入学会相关的当前问题而提出的建议。
