Patients with Heart Failure

Steve McCabe Excerpts

Thursday 11th March 2021 Westminster Hall

[Steve McCabe (Birmingham, Selly Oak) (Lab) [V]]

It is a pleasure to see you in the Chair, Mr Mundell.

As chair of the newly formed all-party parliamentary group on heart valve disease, I congratulate the hon. Member for Strangford (Jim Shannon), a co-founder of that new all-party group, on securing the debate. The aim of the all-party group is to increase awareness of heart valve disease in the United Kingdom, and help ensure that patients receive timely diagnoses and the optimal management and treatment of their condition.

Heart valve disease affects approximately 1.5 million people in the UK. As we have heard, patients can experience fatigue, shortness of breath and chest tightness and/or pain. The most common form of heart valve disease is aortic stenosis, which affects about one in eight people over the age of 75. Unfortunately, awareness and knowledge of the condition in the general population is alarmingly low: in a recent survey, only 3.8% of people really knew what aortic stenosis was. People with heart valve disease have poor survival rates without prompt treatment, and longer waiting times inevitably lead to worse outcomes. However, as we have heard, heart valve disease is a very treatable condition, particularly if patients are diagnosed early.

The all-party group receives secretariat support from Heart Valve Voice, with which I have worked closely on several projects. Most recently, I have been working with Wil Woan, its chief executive, on the “100,000 Conversations” initiative, a campaign focused on improving awareness by encouraging people to discuss their condition with friends and relatives, particularly the symptoms, as well as access to diagnosis and treatment. I should perhaps confess that I had open heart surgery for a repair to my mitral valve back in 2012, and so feel very familiar with many of the issues people raise. I recently had the opportunity to hold one of these conversations with the shadow Health Secretary, my right hon. Friend the Member for Leicester South (Jonathan Ashworth), and I know Heart Valve Voice would be delighted if I could persuade the Minister to also take part in one.

We are also working on a campaign called “Just Treat Us”, which concentrates on encouraging patients to see their doctor if they are experiencing symptoms such as breathlessness, dizziness or fatigue, as well as encouraging care centres to treat patients, especially as the country starts to move out of lockdown. A simple stethoscope test is often all that is needed to identify a heart valve problem. Delaying treatment leads to worse outcomes, but with timely treatment, people can go back to a good—or even a better—quality of life.

As we have heard from the hon. Member for Strangford, covid-19 has had a significant impact on the investigation and care of people with heart valve disease, as with many other conditions. It has been reported that 100,000 fewer heart operations were carried out in 2020 compared with 2019. It has also been reported that 45,000 cardiac procedures have been cancelled.

When I had my mitral valve repaired, I was in an operating theatre for over seven hours. I was in intensive care for three days and spent another two weeks in hospital, and it took me approximately six months to fully recover. Transcatheter aortic valve implantation—TAVI— has been introduced as an alternative therapy to replace damaged aortic valves in patients who are considered high risk for traditional open-heart surgery. The procedure is less invasive, and patients can be discharged from hospital in a short period, allowing them to return to normal life while also saving hospital resources. As the hon. Member for Strangford said, he and I once witnessed a transcatheter procedure carried out on an 85-year-old gentleman at St Thomas’s. He had a local anaesthetic and was largely alert during the procedure. He was able to return home and was working on his allotment within three weeks of the procedure.

The “Valve for Life” initiative, run by the European Association of Percutaneous Cardiovascular Interventions, aims to promote transcatheter valve interventions, which could be crucial in rapidly reducing the waiting list that has been built up during the covid-19 crisis. It has four main goals: to raise awareness of valvular heart disease; to facilitate access to new therapies, such as TAVI; to increase educational standards; and to reduce obstacles to therapy and discrimination in access to care. The overall objectives of “Valve for Life” are to address inequalities in patient access and the disparities between countries in Europe, as well as to inform Government officials, healthcare administrators and healthcare providers about the clinical and economic value of transcatheter heart valve therapies in the management of valvular heart disease.

The UK has the second lowest rate of TAVI procedures per million people in Europe. Even within the UK, there is a large geographical disparity regarding access to treatment, as I think we heard earlier. We are very lucky in this country to have Dr Daniel Blackman, one of our leading interventional cardiologists, spearheading the campaign to raise the volume of transcatheter procedures. As we learn the lessons from the pandemic, I hope this is one area where we might be willing to entertain new thinking.

Heart valve disease is extremely common among older people and will obviously continue to place huge demands on our health service, but with early diagnosis and increased use of TAVI procedures, it need not be a killer. Indeed, it need not impair the quality of life. I hope that in the months and years ahead we can work to increase the use of new treatments and interventions, so that those suffering with heart disease can, in large part, look forward to a long and productive life following timely treatment and prompt rehabilitation support. Once again, I thank the hon. Member for Strangford for securing the debate and for making such an informed contribution.