TAVR or surgery? Cardiologists say better communication would boost care for patients with structural heart disease
![Large peridevice leaks after left atrial appendage occlusion (LAAO) are incredibly rare and not associated with a greater risk of adverse outcomes, according to new research published in JACC: Clinical Electrophysiology.[1] Smaller residual links are more common, however, and associated with a risk of thromboembolic and bleeding events.](/sites/default/files/styles/top_stories/public/2018-08/olderpatient-doctor.jpg.webp?itok=Cv18wcDr)
A majority of cardiologists see room for improvement in the way shared decision-making is used to help patients with structural heart disease choose the best treatment option, according to a new survey from the American College of Cardiology (ACC) and Medtronic.
The survey included responses from more than 150 cardiologists. Results were first shared with the public during a virtual symposium at ACC.21, the ACC’s 70th annual scientific session.
In late 2020, the ACC and American Heart Association collaborated on new recommendations that emphasized the importance of communication when patients present with signs of structural heart disease. When patients have severe aortic stenosis (AS), for instance, cardiologists are asked to help them choose between transcatheter aortic valve replacement (TAVR) and surgery.
However, according to this new survey, 53% of cardiologists think patients with severe AS aren’t as informed as they should be when the time comes to make key treatment decisions. Fifty-seven percent of cardiologists see patient preparation as one way to help address this issue.
“This survey gives the cardiology community clearer insights into how to enhance the conversations we are already having and align on patient priorities—with the ultimate goal of achieving a more timely, individualized approach to aortic stenosis care,” Purvi Parwani, MD, director of the Women's Cardiovascular Health Clinic at Loma Linda International Heart Institute and a panelist at the ACC.21 virtual symposium, said in a prepared statement.
What steps do cardiologists think should be taken to improve patient preparation? According to the survey, the No. 1 recommendation (59% of respondents) is to have a family member or friend attend the appointment, take notes and ask follow-up questions as needed. The use of a patient decision aid (53%) and coming to the appointment with a list of questions (46%) were other commonly recommended solutions.
Additional coverage of ACC.21 and other industry conferences is available here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.