Routine follow-up for patients with prosthetic valves: the value of a nurse-led valve clinic

Abstract

Br J Cardiol 2012;19:76–8 T see whether a nurse-led clinic might be useful we audited how often patients discharged from follow-up were elsewhere seen in the community and how often events were picked up in patients being seen in a nurse-led valve clinic. We audited patients implanted with an OnX bileaflet mechanical heart valve between 1999 and 2010 by postal audit asking for details of follow-up and adverse events. We also analysed the outcome and adverse events from our nurse-led clinic over 30 months between 2009 and 2011 using our valve clinic audit database. There were 188 OnX patients of whom only 125 (66%) were receiving regular cardiology follow-up. Of those in regular follow-up, there were 16 (13%) valverelated adverse events, and this was similar to those not receiving follow-up, 9 (14%). Only 126 (67%) had regular dental surveillance. In the valve clinic, there were 199 visits by 132 patients. Echocardiograms were required on eight visits (4%). There were three hard events (as defined by International Guidelines), 19 visits (10%) revealed adverse events requiring a cardiologist and six (3%) revealed events not requiring a cardiologist. In conclusion, a nurse-led clinic provides effective long-term monitoring of valve patients. Large proportions of patients are discharged from cardiology/surgical units and are at risk of adverse valve-related events.