Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to update NHS England’s Commissioning Framework for transcatheter heart valve interventions, including procedures for (1) tricuspid regurgitation, (2) mitral regurgitation, (3) aortic stenosis and (4) valve-in-valve interventions, in the light of any new evidence and clinical advancements since the Framework was introduced in 2013.

NHS England commissions the National Institute for Cardiovascular Outcomes Research (NICOR) to collect national data on all transcatheter aortic valve implantation (TAVI) procedures.

NICOR currently reports aggregate TAVI mortality and does not disaggregate outcomes by clinical indication. However, over the past decade, TAVI mortality has significantly reduced with, for example, in-hospital mortality decreasing from approximately 3% to 4% in 2013/14 to 0.8% in 2022/23.

Aortic stenosis pathways continue to be reviewed to improve access and productivity. In August 2025, a new policy proposition proposal (PPP) for TAVI in aortic valve disease and bioprosthetic valve failure was submitted for further consideration. NHS England is currently reviewing this PPP in line with the national methods for clinical commissioning policy development.

A PPP has also been submitted for transcatheter edge-to-edge repair for the treatment of severe tricuspid regurgitation in patients who remain symptomatic despite optimal medical therapy, and is being considered in line with NHS England’s national policy methods.

NHS England routinely commissions transcatheter edge to edge (TEER) repair for primary/degenerative mitral regurgitation (MR). A clinical commissioning policy for TEER for secondary/functional MR has been developed and is awaiting consideration by the Clinical Priorities and Advisory Group.