Interventional cardiology

Medicare-funded TAVI for high risk patients 


Patients who are unable to undergo heart-valve surgery will have better access to an alternative, following the listing of TAVI on the Medicare Benefits Schedule.

From November 1, Medicare rebates will be available for Transcatheter Aortic Valve Implantation (TAVI) for patients with symptomatic with severe aortic stenosis deemed high-risk for surgical aortic valve replacement or inoperable.

Earlier this year, the idea for MBS-listing triggered controversy after surgeons opposed the proposed model in which either an interventional cardiologist or a cardiothoracic surgeon was funded as the principle operator arguing it was unsafe for patients.

Related news:  Cardiothoracic surgeons boycott TAVI funding model

This model was ultimately approved – however the limbic understands new policies – including accreditation requirements for doctors and hospitals offering TAVI – have been put in place to address the Australian and New Zealand Society of Cardiac and Thoracic Surgeons’ concerns.

Professor Raviny Bhindi, an interventional cardiologist at Royal North Shore Hospital in Sydney, said the MBS listing will improve patient access to the procedure.

“This is an important therapy for these high-risk patients who would undergo open heart surgery at a high risk of complications or patients being deflected and getting no treatment.”

A second new  listing will mean MBS subsidies from this month for percutaneous insertion of a left atrial appendage closure device to occlude the left atrial appendage in patients with non-valvular atrial fibrillation.

The procedure for stroke prevention will be subsidised for  patients who can’t take long-term anticoagulants due to high risk of bleeding, said Professor Bhindi.

“It is particularly exciting for those such individuals who are younger who would ordinarily be exposed to the long-term risks of blood thinners.

“If you were at high risk of bleeding in the brain or GI system or you have bled before then this device could offer a reduction in that setting.

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