A simple way to ensure more heart patients with severe AS receive the care they need
Aortic valve replacement (AVR) is a safe, effective treatment option for symptomatic severe aortic stenosis (AS), but many patients who would benefit from either transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) are still not receiving the care they need.
Sending electronic alerts to clinicians when a patient’s transthoracic echocardiogram (TTE) results show signs of severe AS is one way to ensure more high-risk patients undergo TAVR and SAVR, according to new research presented at ACC.25 in Chicago and published in Circulation.[1]
The study’s authors tracked data from more than 900 patients who underwent a TTE and showed clear warning signs of severe AS. All patients were evaluated from March 2022 through November 2023. The mean age was 77 years old and 47% of patients were female.
Each study participant was randomized to either be part of the electronic alert intervention or undergo care as normal. The electronic alerts included “patient-specific clinical guideline recommendations” and were sent both through the electronic medical record and email.
Overall, after one year, the AVR rates were 48.2% for the electronic alert group and 37.2% for the usual care group. Among patients who were confirmed to have symptomatic AS, meanwhile, the AVR rates were 60.7% for the electronic alert group and 46.5% for the usual care group.
The authors emphasized that the electronic alerts appeared to be the most effective in patients over the age of 80, women and patients evaluated in an inpatient setting.
“AS is deadly when not treated in a timely manner, yet its undertreatment is a widespread problem that is the focus of ongoing national quality improvement initiatives,” senior author Sammy Elmariah, MD, an interventional cardiologist and chief of interventional cardiology at the University of California San Francisco, said in a statement. “Our study establishes electronic provider notifications as a simple and effective tool to help ensure that severe aortic stenosis is appropriately recognized and treated.”
“Using data from our healthcare system, we were able to evaluate if a simple intervention—electronic messages sent through medical records and email—could improve care for patients with severe AS,” added first author Varsha Tanguturi MD, a cardiologist with Massachusetts General Hospital. “We found that electronic notifications improved rates of AVR, particularly in the elderly and in women, and improved survival for patients.”
Edwards Lifesciences, a company known for developing both TAVR and SAVR technologies, funded this research. However, the authors were “solely responsible” for the study’s design and how it was carried out.
Click here to read the full study in Circulation.
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.