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Structural Heart Disease

We oversee, fund and evaluate treatment services for structural heart disease.
About

The following treatment services are planned, coordinated, monitored, funded and evaluated on a provincial level:

  • diagnostic cardiac catheterization
  • open heart valve surgery 
  • transcatheter aortic valve implantation (TAVI)
The highest volume medical procedures in this program treat abnormalities of the heart valves. Procedures include:
  • surgical valve repair/replacement
  • transcatheter heart valve (THV) interventions

 Heart valve treatments for adults are offered at:

  • Kelowna General Hospital
  • Royal Jubilee Hospital (Victoria)
  • Royal Columbian Hospital (New Westminster)
  • St. Paul's Hospital (Vancouver)
  • Vancouver General Hospital

In addition, we fund the Pacific Adult Congenital Heart Clinic at St. Paul's Hospital which provides ongoing management for adults born with a structural heart abnormality. 

Program highlights

Transcatheter heart valve (THV) is an umbrella term that refers to minimally invasive cardiac procedures that are performed using a small hollow tube (catheter)  to either replace or repair one or more of the four heart valves. This can be done through a small hole in the leg or the chest wall.  Transcatheter aortic valve implantation (TAVI) is the most commonly performed THV procedure in BC.

The provincial THV program was established in 2011 to capitalize on BC's pioneering accomplishments, support patients' access to innovative treatment options, and promote excellence of care.  The objectives of the BC THV Program are to:

  • promote evidence-based program development
  • monitor quality of care
  • coordinate timely access to treatment
  • facilitate provincial excellence and leadership.

The current indications for TAVI in BC reflect the Canadian Cardiology Society guidelines, and include:

  • severe symptomatic aortic stenosis
  • higher risk for open heart surgery as documented by a BC surgeon
  • heart team consensus of treatment decision
  • likelihood to derive significant quantity and quality of life.

Technology, procedural approaches and scientific evidence are rapidly evolving. Multiple new generation devices are under development and clinical trials will inform future indications and changes in practice.

In collaboration with the heart teams at each site, we conduct an annual quality review to monitor adherence to indications, quality of care, and promote provincial excellence. The Cardiac Services BC-led approach to THV has resulted in excellent outcomes compared to data from other international registries.

Procedure volumes

In 2014/15, BC's cardiac centres performed the following cardiac procedures, funded by Cardiac Services BC:

  • 1255 surgical valve repair/replacements
  • 318 transcatheter heart valves aortic valve implantations

We monitor multiple aspects of heart disease and health system statistics in BC, including wait times and patient outcomes for these procedures.

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SOURCE: Structural Heart Disease ( )
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