TAVI now available on Medicare for more patients living with severe aortic stenosis

The minimally invasive, non-surgical intervention – transcatheter aortic valve implantation (TAVI) – is now available on Medicare for more privately insured patients living with severe aortic stenosis.

From March 1, 2022, the TAVI Medicare Benefits Schedule (MBS) listing will be expanded to include patients deemed at intermediate surgical risk on the grounds of acceptable safety, efficacy, and cost-effectiveness, when compared with surgical aortic valve replacement (SAVR).

An estimated 97,000 Australians are living with severe aortic stenosis, with those aged 65 years and above most affected. If not identified, and treated, more than 50 per cent of those with severe aortic stenosis may die within two years.

According to Dr Yohan Chacko, Interventional Cardiologist, Greenslopes Private Hospital, TAVI may offer significant benefits over surgery for those living with severe aortic stenosis.

“Compared with surgical aortic valve replacement, TAVI offers reduced procedural time, less time in hospital, a shorter recovery period, lower risk of complications, and improved quality of life.

“In addition, many patients undergoing TAVI are often discharged within 48 hours, offering meaningful patient benefits regarding time in hospital and recovery, compared to surgery.”

Aortic stenosis is both under-diagnosed and under-treated in Australia, with approximately 90 per cent of patients not receiving treatment.

Dr Kean-Seng Lim, General Practitioner at Mt Druitt Medical Centre, Sydney, said primary care plays an important role in the timely diagnosis and subsequent treatment of aortic stenosis.

“The first presentation of aortic stenosis is frequently to GPs, especially with older patients.

“Therefore, cardiac auscultation should form part of an annual comprehensive cardiovascular disease (CVD) risk assessment for every Australian over 65 years of age.”

“Patients found to have any abnormalities should be referred to a cardiologist for further examination including echocardiography – the test of choice for heart valve disease.

“Those diagnosed with aortic stenosis should be referred to a cardiologist and/or heart team to ensure they are provided with the best treatment option for them,” Dr Lim said.

In Australia, the Edwards Lifesciences SAPIEN 3 Transcatheter Heart Valve System is indicated for the treatment relief of aortic stenosis in patients with symptomatic heart disease due to severe native calcific aortic stenosis who are judged by a Heart Team, including a cardiac surgeon, to be appropriate for the transcatheter heart valve replacement therapy.

“SAPIEN 3 TAVI offers faster procedural times – an average of 45 minutes per procedure – allowing for the treatment of three patients within the time it takes to perform one SAVR procedure,” said Dr Chacko.

Economic modelling in the recently published whitepaper, titled ‘Our Hidden Ageing – Time to Listen to the Heart’, developed by experts at the Baker Heart and Diabetes Institute, revealed that offering a TAVI to those aged 65 years and over could potentially prevent $117 million in productivity loss in a single year due to withdrawal from productive activities.