University of Cambridge

3

CCU090

Aortic valve stenosis is a chronic heart condition where there is an abnormal narrowing of the aortic valve. This impacts the heart’s ability to efficiently pump blood to the rest of the body. Transcatheter aortic valve implantation (TAVI) offers treatment to high risk, older and previously inoperable patients that is safer than aortic valve replacement surgery (AVR). TAVI is a less invasive procedure performed through a catheter to replace a damaged aortic valve, while AVR typically involves open-heart surgery to replace the valve directly. While AVR patients undergo cardiac rehabilitation, the role of rehabilitation in TAVI patients is unclear. These patients are usually sent home within days of the intervention, and most do not get referred to cardiac rehabilitation (a program that supports patients regain strength and function following surgery). Therefore, this poses the questions: 1. Do these patients benefit from undertaking cardiac rehabilitation? 2. Was their care compromised during the COVID-19 pandemic? The aim of this research project is to investigate whether patients with aortic valve stenosis, who are treated with a TAVI procedure, benefit from undertaking cardiac rehabilitation. This is important because these patients are often frail with multiple other diseases, thus they are likely to benefit from rehabilitation, but data to support this is limited. Our study will assess the uptake rates to cardiac rehabilitation before and after the COVID-19 pandemic and determine whether patients who attend rehabilitation, after undergoing TAVI surgery, achieve better outcomes and live longer healthier lives compared to patients who do not attend rehabilitation.

This study will generate new knowledge to inform the after-hospital treatment of patients following TAVI surgery. It will inform the best allocation of scarce healthcare resources by helping older, frail, and vulnerable patients, who are most in need of support, and most likely to benefit from rehabilitation. Finally, this study could prove valuable for policymakers, hospital systems and researchers by informing new research, new clinical pathways, and further funding decisions as it will likely be the largest study of its kind to investigate the benefits of cardiac rehabilitation following TAVI procedures. Visit the BHF Data Science Centre website for more detailed information about project outputs. https://bhfdatasciencecentre.org/projects/ccu090/

This project accessed the following datasets within the Trusted Research Environment(s) for CVD-COVID-UK / COVID-IMPACT: - ENGLAND: - Civil Registration - Deaths - COVID-19 SARI-Watch (formerly CHESS) - Covid-19 Second Generation Surveillance System - Covid-19 UK Non-hospital Antibody Testing Results - Covid-19 UK Non-hospital Antigen Testing Results - COVID-19 Vaccination Adverse Reaction - COVID-19 Vaccination Status - Emergency Care Data Set (ECDS) - GPES Data for Pandemic Planning and Research (COVID-19) - Hospital Episode Statistics Accident and Emergency - Hospital Episode Statistics Admitted Patient Care - Hospital Episode Statistics Critical Care - Hospital Episode Statistics Outpatients - ICNARC: Intensive Care National Audit and Research Centre - Improving Access to Psychological Therapies Data Set - Medicines dispensed in Primary Care (NHSBSA data) - Mental Health Services Data Set - MSDS (Maternity Services Data Set) - NICOR – MINAP: Myocardial Ischaemia National Audit Project - NICOR – NACRM: National Audit of Cardiac Rhythm Management - NICOR – NACSA: National Adult Cardiac Surgery Audit - NICOR – NCHDA: National Congenital Heart Disease Audit - NICOR – NHFA: National Heart Failure Audit - NICOR – PCI: Percutaneous Coronary Interventions - NICOR – TAVI: Transcatheter Aortic Valve Implantation - Secondary Care Prescribed Medicines (EPMA) - Secondary Uses Services Payment By Results - Sentinel Stroke National Audit Programme Clinical Dataset - Uncurated Low Latency Hospital Data (Admitted Patient Care, Outpatients, Critical Care)

09/10/2024

02/08/2025

15/12/2024

De-Personalised

15/12/2024

TRE