Families to be contacted after heart op deaths
FAMILIES of patients who died following a type of heart surgery at Swansea’s Morriston Hospital will be contacted after concerns were raised during a review.
The review found a higher than expected mortality for mitral valve surgery, though the overall mortality rate at the hospital’s cardiac surgery service was consistent with the Wales and England average.
Swansea Bay University Health Board members heard more about the review and what actions were being taken at a meeting on October 7.
A board report said input was being sought from the Royal College of Surgeons and Society for Cardiothoracic Surgery around a review of case notes of patients who died following mitral valve surgery, and to establish any improvements which should be put into practice.
A health board action plan said an internal review, relating to 19 cases, had been completed.
The cardiac surgery service review was via a national programme called Getting It Right First Time, which assesses and tries to improve variations in medical care.
It also found higher rates of follow-up cardiac surgery due to bleeding and other causes, higher rates of deep sternal wound infection, and higher rates of post-operative neurological and renal dysfunction.
Health board executive medical director Dr Richard Evans, who presented the report, said: “We took some immediate actions once we heard about that.”
Only mitral valve specialist surgeons, he said, were now carrying out this type of surgery, and only consultants were operating more generally within the service for the time being.
The action plan has been agreed with an-wales health committee, and an internal group has been set up to oversee its implementation.
But Dr Evans took issue with the deep sternal wound infection finding, explaining that a slightly different method of counting had been used by the reviewers compared to audited data which was based on health board submissions.
“We feel our rate of infection is actually slightly lower than the national average, rather than substantially higher,” said Dr Evans.
Other actions to date include establishing a multi-disciplinary surgery team to assess whether a mitral valve repair would be more appropriate for a patient than a replacement.
Medics will also look to reduce patients’ pre-operative stay in hospital.
Concluding a discussion about the review and action plan, health board chairwoman Emma Wollett said: “I think the action plan is a very robust one.”
A separate review a couple of years ago criticised the health board for the care of some elderly patients who died after being assessed for a heart procedure.
The Royal College of Physicians (RCP) was brought in by what was then Abertawe Bro Morgannwg University (ABMU) Health Board to review the clinical management of patients with a narrowed aortic valve between January 2015 and November 2018.
The patients were waiting for, or had been considered for, a procedure called trans-catheter aortic valve implantation.
The RCP said the care of 23 of the 32 patients who died after having been assessed was unsatisfactory.