Promoting shared decision-making for the treatment of heart valve disease in Canada

Research co-lead: 

  • Sandra Lauck
    University of British Columbia 

Research user co-lead:

  • Jacqueline Forman
    St. Paul's Hospital

Team members: 

  • Sandra Carroll
    McMaster University
  • Dr. Jennifer Baumbusch
    University of British Columbia
  • Dr. Anita Asgar
    Transcatheter Valve Therapy Clinic
  • Dr. Leslie Achtem
    Vancouver Transcatheter Heart Valve Program, St. Paul’s Hospital
  • Amanda Smith
    McMaster University 
  • Dr. Richard Cook
    Vancouver General Hospital
  • Michelle Tyler
    University of British Columbia, St. Paul's Hospital
  • Krystina Lewis
    University of Ottawa

After the age of 70, about 10% of British Columbians will develop a heart valve disease called aortic ('a-yor-tic') stenosis. Over time, the leaflets of the heart valve become harder and blood cannot pass through easily to travel to the rest of the body. This is like having a garden hose with a spout that cannot be loosened. The only treatment is to replace the valve. If this is not done, most people with the worse aortic stenosis will die within a year.

As of recently, this valve replacement can be done in one of two ways: either with open heart surgery (surgical aortic valve replacement) or using a small hollow plastic tube threaded through a leg artery or another way (transcatheter aortic valve replacement). Both ways have different risks and benefits, and many patients can have one way to the other.

The reason our group of clinicians, researchers and patients want to come together is to help patients and their doctors and other health care professionals decide about the way to change the valve together that is the right one for each patient. It is also important that this decision matches the patient's values and beliefs about their health and their goals. This is called shared decision-making.

Our goals are to look about what we know about the treatment of aortic stenosis and shared decision-making and study how we can use this information to improve the care of older British Columbians and Canadians who need valve surgery.