I WORK WITH THE HEART VALVE TEAM.
We co-manage our patients
TO ENSURE OPTIMAL
OUTCOMES

If in doubt, refer to the 2020 ACC/AHA Guidelines.

Download the Guidelines One-Pager

Joy, real TAVR patient; doctor, actor portrayal

MANY PATIENTS ARE NOT CONSISTENTLY REFERRED—AND THE CONSEQUENCES CAN BE SIGNIFICANT1-4

A 2022 study revealed that

Graphic visualizing a total of 43% of patients with a likely indication for AVR were not referred to a valve specialist and did not receive AVR

of patients with a likely indication for AVR were not referred to a valve specialist and did not receive AVR1

Peer Perspectives:

Clinician and patient conversations—partnering with a Heart Valve Team sooner

Video thumbnail of JaNae’ Richard, MD and Danielle Kelley, APRN, FNP-BC, discussing the importance of partnering with a Heart Valve Team sooner

“For me, I want my heart valve failure patients to get to the heart [valve] team as soon as possible.”

-
JaNaé Richard, MD
General Cardiologist

“Collaboration is definitely the key when you have multiple providers and specialties involved in the continuity of the care of the patient.”

-
Danielle Kelley, APRN, FNP-BC
Primary Care Nurse Practitioner (PCNP)

The ACC/AHA Guidelines support the need for prompt referrals5

Earlier referral to a Heart Valve Team means your patients can be evaluated and receive timely treatment.2

Hank | Age 68: HG-LEF

Severe AS, asymptomatic

Patient photo

About Hank
Hank is a recent widower who volunteers at his local animal shelter on the weekends.

Medical history

Hank was diagnosed with SAS but was not referred at the time due to his comorbidities. However, he was re-evaluated by a new cardiologist after his retired.

Icon of a triangle with an exclamation point

Comorbidities6-8

Diabetes, CKD, and COPD

Icon of a medication bottle

Medications9-11

Metformin, sulfonylurea, empagliflozin, and tiotropium/olodaterol

View ECHO findings

AS=aortic stenosis; CKD=chronic kidney disease; COPD=chronic obstructive pulmonary disease; HG-LEF=high gradient, low ejection fraction; SAS=severe aortic stenosis.

AVA5,12
0.6 cm2
Gradient5,12
48 mmHg
LVEF5,12
35%
Peak velocity5,12
4.2 m/s

Would you conduct further evaluation of this patient?

View treatment considerations

ACC=American College of Cardiology; AHA=American Heart Association; AS=aortic stenosis; AVA=aortic valve area; HG-LEF=high gradient, low ejection fraction; LVEF=left ventricular ejection fraction; SAS=severe aortic stenosis.

Icon of a heart

Diagnosis:

Severe AS
Stage C2

Intermediate surgical risk6

Treatment considerations

AVR is associated with a survival benefit in patients with HG-LEF sSAS.12 Further, patients with C2 subtype have a class I indication for AVR in the ACC/AHA Guidelines.5

All patients with SAS should be referred for evaluation, regardless of symptom presentation.5

Download the ACC/AHA Guidelines

ACC=American College of Cardiology; AHA=American Heart Association; AS=aortic stenosis; AVR=aortic valve replacement; HG-LEF=high gradient, low ejection fraction; SAS=severe aortic stenosis; sSAS=symptomatic severe aortic stenosis.

Earlier referral to a Heart Valve Team is the first crucial step to lifesaving outcomes for your SAS patients2

This is a portrayal of an SAS patient and not a real patient.

The guidelines highlight the importance of shared decision-making

"For patients with VHD for whom intervention is contemplated, individual risks should be calculated for specific surgical and/or transcatheter procedures, using online tools when available, and discussed before the procedure as a part of a shared decision-making process"5

– The 2020 ACC/AHA Guidelines

Icon of two hands holding up a heart emphasizing the importance of collaboration between the Heart Valve Team and primary cardiologists

Engagement between the Heart Valve Team and the primary cardiologist is of critical importance5

Icon of 3 people representing HCPs in a multidisciplinary heart valve team

Patients with severe aortic stenosis (SAS), also known as heart valve failure, should be evaluated by a multidisciplinary Heart Valve Team when intervention is considered5

Icon of a heart representing ACC/AHA guidelines for AVR

AVR is recommended for patients with symptomatic SAS aged 65-805

Additionally, there is a class I recommendation for AVR in SAS and exertional symptoms, or with reduced LVEF, or if undergoing other cardiac surgery5

Referring to a Heart Valve Team and engaging in shared decision-making does not result in delayed treatment—it ensures your patients' individual needs are thoroughly considered.2,13,14

ENGAGE WITH A HEART VALVE TEAM SOONER

Prompt referral to a Heart Valve Team is critical to better patient outcomes.2

Partnership makes a difference

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References: 1.Flannery L, Etiwy M, Camacho A, et al. Patient- and process-related contributors to the underuse of aortic valve replacement and subsequent mortality in ambulatory patients with severe aortic stenosis. J Am Heart Assoc. 2022;11(11):e025065. 2.Lancellotti P, Magne J, Dulgheru R, et al. Outcomes of patients with asymptomatic aortic stenosis followed up in heart valve clinics. JAMA Cardiol. 2018;3(11):1060-1068. 3.Redfors B, Pibarot P, Gillam LD, et al. Stress testing in asymptomatic aortic stenosis. Circulation. 2017;135(20):1956-1976. 4.Otto CM. Mind the gap: missed valve disease diagnosis. Heart. 2018;104(22):1810-1811. 5.Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021;143(5):e72-e227. 6.Leon MB, Smith CR, Mack MJ, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2016;374:1609-1620. 7.Mentias A, Desai MY, Saad M, et al. Management of aortic stenosis in patients with end-stage renal disease on hemodialysis. Circ Cardiovasc Interv. 2020;13(8):e009252. 8.Steinmetz T, Witberg G, Chagnac A, et al. Transcatheter aortic valve implantation versus conservative treatment in chronic kidney disease patients. EuroIntervention. 2018;14(5):e503-e510. 9.American Diabetes Association. Standards of care in diabetes—2023 abridged for primary care providers. Clin Diabetes. 2023;41(1):4-31. 10.Boehringer Ingelheim Pharmaceuticals. Jardiance (empagliflozin tablets). U.S. Food and Drug Administration. Updated September 2023. Accessed September 26, 2024. https://content.boehringer-ingelheim.com/DAM/7d9c411c-ec33-4f82-886f-af1e011f35bb/jardiance-us-pi.pdf 11.Agustí A, Celli BR, Criner GJ, et al. Global Initiative for Chronic Obstructive Lung Disease 2023 report: GOLD executive summary. Eur Respir J. 2023;61(4):2300239. 12.Li SX, Patel NK, Flannery LD, et al. Trends in utilization of aortic valve replacement for severe aortic stenosis. J Am Coll Cardiol. 2022;79(9):864-877. 13.Coylewright M, O'Neill E, Sherman A, et al. The learning curve for shared decision-making in symptomatic aortic stenosis. JAMA Cardiol. 2020;5(4):442-448. 14.Nkomo VT, Gardin JM, Skelton TN, et al. Burden of valvular heart diseases: a population-based study. Lancet. 2006;368(9540):1005-1011.

Patients and/or clinicians quoted on this website have received compensation from Edwards Lifesciences.