A review of patient charts showed the most common reasons for not referring for surgery were 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. Only 66 percent of the patients who did not undergo surgery survived 12 months later.
Bach suggests cardiologists become more familiar with guideline recommendations and the data on which they are based, discuss options more fully with patients, and when possible, involve a cardiac surgeon in consultation.
Additional Authors: Derrick Siao, M.D., resident at University of California-San Francisco; Steven E. Girard, M.D., cardiologist, Ypsilanti, Mich., Claire Duvernoy, M.D., cardiologist and assistant professor at U-M Medical School and director of the Women's Heart Program at VA Ann Arbor Healthcare System; and Sarah Gualano, M.D., cardiologist and assistant professor at Southwestern Medical Center.
Funding: Edwards Lifesciences.
Reference: Circulation Cardiovascular Quality and Outcomes, DOI: 10.1161
U-M Cardiovascular Center
SOURCE University of Michigan Health System
|SOURCE University of Michigan Health System|
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