What is the value of a nurseled clinic for patients with replacement heart valves

Background: Long-term regular specialist surveillance is recommended to reduce the risks of complications arising after heart valve surgery. This could be delivered by a nurse-led valve clinic. Aims: To determine how often clinical events are detected within a nurse-led valve clinic and how often a cardiologist or sonographer is required. Methods: Nurse-led valve clinic outcomes and events were analysed over 48 months from 2010 to 2013. An endpoint was any new symptom or event or the need for an unscheduled echocardiogram. Results: There were 544 visits in 206 patients. Endpoints were found in 178 visits (33%). A cardiologist was required in 100 visits (18%) to see the patient in 27 and give advice in 73. Another clinician was needed in 8 visits. Unscheduled echocardiography was required in 70 (13%) visits. Conclusion: A nurse-led valve clinic is feasible. Clinical endpoints are detected frequently and enhanced long-term care can be safely provided. Review or discussion with a cardiologist or unscheduled ...