May 27th, 2014
Choosing a Prosthetic Valve: What Do You Say to Your Patient?
This post is the second in our series “What Do You Say to Your Patient?” In this series, we ask members to share with us how they interpret a complex or controversial issue for patients and explain whether it relates to their health. For the first post, relating to the CoreValve trial findings, click here.
The following scenario stems from the recommendations for prosthetic valve choice that are included in the 2014 AHA/ACC Guideline for the Management of Patients with Heart Disease.
Your patient is a 60-year-old man with a bicuspid aortic valve that is severely stenosed. He is mildly symptomatic, has no comorbidities, and takes no medications. He is very athletic and wants to remain active. The patient says that he is trying to decide whether to request a bioprosthetic or mechanical valve.
What do you say to your patient?
How strongly do you push in one direction or the other?
How do you help him understand the trade-off?