Impact of a Patient Decision Aid for Treatment of Aortic Stenosis

Pilot Randomized Trial of a Patient Decision Aid for Treatment of Aortic Stenosis

This project will evaluate the impact of a patient decision aid created by the American College of Cardiology for patients considering treatment of aortic stenosis. The decision aid describes surgical aortic valve replacement (SAVR) surgery and transcatheter valve replacement surgery (TAVR).

The pilot trial will enroll patients who are coming in to see a valve specialist (cardiac surgeon or interventional cardiologist) to discuss treatment options for aortic stenosis. The study will recruit patients at Massachusetts General Hospital or at the University of Colorado Health Heart and Vascular Center, Anschutz Medical in Denver, Colorado and randomly assign them to usual care arm or decision aid arm. The decision aid will be given to the participant in clinic at the time of their appointment. Patient participants in both arms will be asked to complete a short survey after the visit. The survey will assess knowledge, treatment preference, shared decision making (SDM), and decisional conflict. Analyses will compare the two arms on these outcomes to generate preliminary data on impact of the intervention.

Inclusion Criteria:

• Adults 18-85 years only
• English speaking
• Severe aortic stenosis, defined as an aortic valve area < 1 cm2
• Never had AVR or who had previous AVR > 6 months previous
• Patients perceived by the clinician to be at low or intermediate risk for SAVR

Exclusion Criteria:

• Concomitant disease of another heart valve or the aorta that required either transcatheter or surgical intervention