People requiring heart surgery are dying, says Cardiac Society

People in need of heart surgery are dying on waiting lists in Ireland, the Irish Cardiac Society has warned.

Consultant cardio-thoracic surgeon Michael Tolan, on behalf of the organisation, has said the consequences of delay are much greater for cardiac surgery patients than for other groups.

After 18 weeks, there is an unacceptable risk of death, deterioration of heart operative mortality, he said.

There are more than 4,350 people on waiting lists for cardiac surgery around the country; almost 1,800 have been waiting six months or more and more than 420 have been waiting more than 15 months. Time on the waiting list is measured from acceptance for surgery to performance of the operation.

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Instead of the present maximum waiting time of 15 months, the society has called for a national maximum waiting time of 18 weeks for non-urgent cardiac surgery, which includes procedures to repair faulty heart valves and widen narrowing blood vessels.

Maximum time

“That maximum time is achieved in the UK, Northern Ireland and even in the poorest of countries in the western world,” Mr Tolan said.

“A patient with severe aortic stenosis [narrowing of the aortic heart valve] with dyspnoea [difficulty breathing] has a lifetime expectancy of two years. A 15-month waiting time is clearly ludicrous.”

The surgeon, who practises at St James’s Hospital Dublin, acknowledges that waiting lists, in a universally accessible, publicly funded health system with limited resources, are necessary for the efficient use of resources and are not in themselves sign of problems.

“Complete elimination of a surgical waiting list would be exceedingly expensive and inefficient, and would not necessarily be associated with improved results,” Mr Tolan said.

‘Level of priority’

“However, for a waiting list to not be detrimental to individual patients’ outcomes, it requires patients to be assigned a level of priority according to the medical condition they have and thereafter a maximum recommended time established.”

He said patients awaiting cardiac surgery who have ischaemic heart disease (narrowing of blood vessels), severe aortic stenosis and other forms of diseased heart valves must be differentiated from other conditions, such as orthopaedics or ophthalmology, that have less impact on patients’ life expectancy.

He also highlighted the economic cost of long waiting times including the direct and indirect cost of being ill, repeated or lengthy hospitalisations, and significant reductions in the ability to work for both patients and their families.