Eligible patients can now have a potentially life-changing heart procedure at our Castle Hill Hospital and be discharged the same day.
Transcatheter Aortic Value Implantation (TAVI) is used to improve the blood flow to the heart by replacing an aortic valve that doesn’t open fully. This can significantly improve the patients’ quality of life, helping to reduce chest pain, breathlessness and fatigue, and give patients more energy, improving their mood and boosting their overall health.
Chris Garforth was the first patient to undergo the same-day procedure – coming into Castle Hill at 7.30am on the day of the procedure and being discharged at 4pm that day.
He first realised something “wasn’t quite right” 18 months ago when, despite being a keen mountain biker, he found he was having to stop his bike on the hill out of his village as he’d run out of breath.
After tests revealed he had signs of heart failure and severe aortic valve stenosis, he was referred to the TAVI team by the Cardiology team at Scarborough Hospital.
He said: “I met Dr Balasubramaniam in early March and within three weeks I was down there for a CT scan. In short order, I had an appointment for TAVI itself.
“My goals in getting this sorted out were to make sure my heart would do its job for a few more years – and I am really looking forward to getting back on my bike.
“That won’t be for a while yet, but I noticed the difference straight away. After 24 hours the breathlessness had vanished and 48 hours after the procedure, I walked to the river Derwent and back again with my daughter. Before the procedure, I couldn’t do that without stopping for breath but two days later I didn’t need to stop at all, so it’s sorted out a major part of the problem.”
Adding that he’s taking it steady but feeling “really good”, Chris said being discharged the same day had also been a significant benefit.
He said: “One of the best things was being able to sleep in my own bed, rather than on a busy ward, with machines beeping all around. With the best will in the world, a ward is not the best place to get a good night’s sleep.
“I also appreciated that if the TAVI team or the Cardiac Day Ward team had any doubt that it wasn’t appropriate to be discharged, it wouldn’t have happened.
“The Cardiac Day Ward team had also impressed on us that we could give them a ring if we had any concerns. Having that confidence that we had immediate access to professional support was a big part of feeling it was okay to be at home rather than in hospital.”
Speaking about the procedure itself, which is carried out under local anaesthetic, Chris added: “Everyone exuded professionalism and confidence and that was a big part of being able to feel relaxed.
“I remember reflecting on everything that’s going on in the world at the moment and thinking that this is what advances in technology should be for – extending and improving the quality of people’s lives.”
Dr Karthik Balasubramaniam, who carried out the procedure alongside Dr Ali Ali and Dr Manish Ramlall, said: “The successful implementation of our first same-day discharge TAVI case represents a significant milestone for our structural heart programme.
“It is well documented that patients recover better in their own homes once they are medically fit to be discharged and, as a team, we are excited about the potential of this approach to transform care delivery – providing not only life-saving treatment but also a more efficient, patient-centred experience.
“It also has benefits for patients who are not suitable for same day discharge, as it will allow us to increase capacity within the TAVI programme, shorten waiting times, increase the number of available beds and free up resources for those with other cardiac conditions too.”
Dr Raj Chelliah’s team – including specialist TAVI nurses Alan Fussey, Kristie Bowsley, and Evangelene Stocks, and Administrator Amanda Oakley-Smith – assess patients’ suitability for same-day discharge through a rigorous and careful pre-procedural assessment.
Dr Balasubramaniam added: “The evolution of TAVI has been marked by continuous innovation in procedural technique, patient selection, and peri-procedural care and a key focus has been the development of streamlined pathways that enhance patient recovery, whilst optimising our resources.
“This first same-day discharge case marks the beginning of a new phase in our TAVI pathway. We now hope to expand on this, using ongoing evaluation and data collection to help us to refine the patient selection criteria to help more patients like Mr Garforth in the future.”
