Hospital Websites Omit Risks for Heart Valve Replacement

Hospital websites that provide information about a new form of heart valve replacement give information about at least one of its benefits, while omitting some or all of its possible risks, according to a recent study.

The study considered hospital websites that presented information about transcatheter aortic valve replacement (or TAVR). Some 262 hospitals with such websites in the U.S. were included in the study and analyzed in May and June of 2014. The review of the websites was conducted by researchers from The University of Pennsylvania and Tufts University Medical School and study results were published in a letter to JAMA Internal Medicine.

Risks for heart valve replacement

Researchers screened for references to 11 potential risks and 11 known benefits for TAVR, and for the way that the procedure was compared to more conventional open aortic valve replacement. While 99% of the websites referred to at least one benefit, only about 26% (69 of the hospitals) referenced even one of the known risks. The most commonly mentioned risk, stroke, was mentioned on only 18% of the sites.

Both TAVR and the more conventional open aortic valve replacement are used to address problems with the aortic valve, the gateway for oxygenated blood to leave the heart and enter the bloodstream to supply the body. Problems with the valve are typically caused by birth defects or, more commonly, aging. One type of problem, aortic stenosis, involves restricted blood flow and increased pressure. The condition can be asymptomatic, but in some cases can involve pain, pressure, or tightness in the chest, difficulty catching one’s breath, fainting, heart palpitations, and inactivity. Eventually, heart failure may result.

Open aortic valve replacement, as the name implies, is open heart surgery that repairs the defective valve by replacing it. In contrast, TAVR, is minimally invasive surgery in which a new valve is put in place through a catheter in a collapsed state and inflated when it reaches its destination. Rather than replacing the old valve, it wedges it out of the way and takes over the defective valve’s functions.

TAVR was approved recently by the FDA and recommended for patients who would otherwise be ineligible for open heart surgery as too risky.

Undisclosed risks of TAVR and hospital malpractice

Although TAVR is safer in some ways than more conventional surgery, it does carry risks. These include stroke, at twice the rate of open heart surgery, as well as the risk of death. Moreover, as the procedure is relatively new, it is not yet known how long the TAVR heart valve will last in comparison to conventional valve replacement.

The study points to the importance of clearly stating the risks as well as the benefits of the procedure on the websites in question, as many Americans get such information online. The authors of the study asserted that “Adequate presentation of risks and benefits of medical therapies is essential to informed decision making by patients.”

In some cases involving serious injury or death, inadequately disclosing the risks of a procedure or treatment to a patient may be grounds for a hospital malpractice lawsuit.

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