Adam’s Heart Valve Surgery Blog

In 2009, many public figures, including Barbara Bush and Robin Williams, needed aortic valve replacement due to heart valve diseases including aortic stenosis. One might think that their successful results and the improvement in mortality rates would inspire patients and the medical community to view heart valve surgery as a blessing.

However, fear about the risk of surgery is among the reasons half of eligible patients are not getting aortic valve replacement surgery, according to a study by physicians at the University of Michigan Health System.

In the study published online ahead of print Nov. 17 in Circulation: Cardiovascular Quality and Outcomes, two-thirds of the patients who did not have valve replacement were suffering symptoms such as shortness of breath that would have improved if they had the surgery.

“Aortic valve replacement not only treats the symptoms, but also saves lives,” says lead author David S. Bach, M.D., professor of internal medicine at the U-M Medical School and cardiologist at the U-M Cardiovascular Center.

Aortic stenosis, a narrowing of the aortic valve opening, is common among older adults. In those age 75 and older, as many as 5 percent have the heart condition. Over time, the heart thickens as it tries to pump blood through the small valve opening which can lead to heart failure.

David S. Bach - Professor Of Internal Medicine, Michigan

The study also suggests that more than a handful of patients were denied surgery. Researchers identified 369 patients from three Michigan hospitals who had aortic stenosis. They had been screened by electrocardiogram. Among them, 191 did not have their aortic valve replaced.

The lack of referrals for surgery occurred in a variety of settings - whether patients saw a community physician or one affiliated with a university or veterans hospital - which suggests a widespread lack of awareness about the benefits of surgery, or overestimation of the risks associated with the surgery.

A review of patient charts showed the most common reasons for not referring for surgery was surgical risk and presence of other major health problems. But surgical risk scores for patients who did not have surgery were lower than doctors had predicted, according to surgical risk guidelines created by the Society of Thoracic Surgery.

Surgery is considered the best treatment for aortic stenosis and the consequences of waiting or passing up surgery are substantial. According to the report, only 66 percent of the patients who did not undergo surgery survived 12 months later.

Keep on tickin!

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About The Author: Adam Pick is a double, heart valve surgery patient and author of The Patient’s Guide To Heart Valve Surgery. This unique book integrates the clinical facts of heart valve surgery with the personal experiences of 78 former valve surgery patients to help patients and caregivers better understand the problems, the opportunities and the realities of heart valve surgery. To learn more about Adam and his heart valve surgery book, click here.

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This entry was posted on Monday, November 23rd, 2009 at 9:25 am and is filed under Studies. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site. Print This Post | EMail This Post.