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. 2015 Apr 8;2(1):e000237.
doi: 10.1136/openhrt-2015-000237. eCollection 2015.

Prosthetic Aortic Valve Selection: Current Patient Experience, Preferences and Knowledge

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Free PMC article

Prosthetic Aortic Valve Selection: Current Patient Experience, Preferences and Knowledge

Nelleke M Korteland et al. Open Heart. .
Free PMC article

Abstract

Objective: Current clinical practice guidelines advocate shared decision-making (SDM) in prosthetic valve selection. This study assesses among adult patients accepted for aortic valve replacement (AVR): (1) experience with current clinical decision-making regarding prosthetic valve selection, (2) preferences for SDM and risk presentation and (3) prosthetic valve knowledge and numeracy.

Methods: In a prospective multicentre cohort study, AVR patients were surveyed preoperatively and 3 months postoperatively.

Results: 132 patients (89 males/43 females; mean age 67 years (range 23-86)) responded preoperatively. Decisional conflict was observed in 56% of patients, and in 25% to such an extent that it made them feel unsure about the decision. 68% wanted to be involved in decision-making, whereas 53% agreed that they actually were. 69% were able to answer three basic knowledge questions concerning prosthetic valves correctly. 56% were able to answer three basic numeracy questions correctly. Three months postsurgery, 90% (n=110) were satisfied with their aortic valve prosthesis, with no difference between mechanical and bioprosthetic valve recipients.

Conclusions: In current clinical practice, many AVR patients experience decisional conflict and suboptimal involvement in prosthetic valve selection, and exhibit impaired knowledge concerning prosthetic valves and numeracy. Given the broad support for SDM among AVR patients and the obvious need for understandable information, to-be-developed tools to support SDM in the setting of prosthetic valve selection will help to improve quality of decision-making, better inform and actively involve patients, and reduce decisional conflict.

Trial registration number: NTR3618.

Keywords: QUALITY OF CARE AND OUTCOMES.

Figures

Figure 1
Figure 1
Preoperative patient preference for final decision in prosthetic aortic valve choice (n=132).

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References

    1. Vahanian A, Alfieri O, Andreotti F et al. , Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC); European Association for Cardio-Thoracic Surgery (EACTS). Guidelines on the management of valvular heart disease (version 2012). Eur Heart J 2012;33:2451–96. 10.1093/eurheartj/ehs109 - DOI - PubMed
    1. Nishimura RA, Otto CM, Bonow RO et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014;129:e521–643. 10.1161/CIR.0000000000000031 - DOI - PubMed
    1. Brennan JM, Edwards FH, Zhao Y et al. Long-term safety and effectiveness of mechanical versus biologic aortic valve prostheses in older patients: results from the Society of Thoracic Surgeons Adult Cardiac Surgery National Database. Circulation 2013;127:1647–55. 10.1161/CIRCULATIONAHA.113.002003 - DOI - PubMed
    1. Ruel M, Chan V, Bedard P et al. Very long-term survival implications of heart valve replacement with tissue versus mechanical prostheses in adults <60 years of age. Circulation 2007;116:I294–300. 10.1161/CIRCULATIONAHA.106.681429 - DOI - PubMed
    1. Korteland NM, Kluin J, Klautz RJ et al. Cardiologist and cardiac surgeon view on decision-making in prosthetic aortic valve selection: does profession matter? Neth Heart J 2014;22:336–43. 10.1007/s12471-014-0564-6 - DOI - PMC - PubMed

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