1770 – Valve-in-valve transcatheter aortic valve implantation for patients with symptomatic structural valve deterioration resulting in aortic stenosis, insufficiency/regurgitation or both

Amendment to MBS item.

Valve- in-valve transcatheter aortic valve implantation (ViV TAVI) is a procedure that can be used to replace a patient’s aortic valve. It is less invasive than open heart surgery. The process involves a replacement aortic valve being inserted via an artery using a guidewire. The valve is then expanded using a balloon catheter. Once the valve is in place the balloon is deflated, and the catheter and guidewire are removed.

Type: Therapeutic technology

Aortic valve stenosis is a type of heart valve disease, whereby the valve between the lower left heart chamber and the aorta is narrowed and doesn't fully open. This reduces or blocks blood flow from the heart to the aorta and to the rest of the body. The condition requires surgery to repair or replace the valve, and without treatment can lead to death.

The specific population for the proposed service in this application is patients with severe, symptomatic aortic stenosis, who have previously undergone surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) but are now experiencing symptomatic structural valve deterioration (SVD), with the bioprosthetic aortic valve failing and resulting in stenosis, insufficiency or both. These patients require a repeat aortic valve replacement, and have been judged by a heart team, including a cardiothoracic surgeon, to be at high risk for open heart surgery.

• PASC consultation: Closed 15 March 2024
• MSAC consultation: MSAC consultation TBA – please subscribe to the MSAC bulletin to be notified when consultation opens for this application

• PASC meeting: 18–19 April 2024
• ESC meeting: -
• MSAC meeting: -