Heart Valve Replacement Risks Often Understated By Hospital Websites: Study

A new report suggests that many hospital websites fail to provide adequate warnings for patients about the risks involved in some forms of heart valve replacement surgery. 

Researchers from Tufts University School of Medicine and the University of Pennsylvania found that only about a quarter of websites operated by hospitals contain appropriate information about the risks of undergoing transcatheter aortic valve replacement (TAVR), while nearly all of them promoted the potential benefits. The findings were published in a letter to JAMA Internal Medicine on January 12.

According to the letter, researchers looked at websites for 262 U.S. hospitals that described TAVR procedures in May and June of 2014. All of the hospitals were listed in the Society of Thoracic Surgeons and the American College of Cardiology’s Transcatheter Valve Therapy Registry. They looked for 11 known potential risks and 11 benefits of TAVR, when compared to an open aortic valve replacement.

According to the findings, more than 99% of the websites contained at least one benefit of TAVR, but only 69 of the sites, about 26%, mentioned any of the known risks. The risk of stroke, which is twice that with TAVR when compared to open aortic valve replacement, was mentioned on 18% of the websites, making it the most commonly mentioned risk. However, only 12% mentioned there was a risk of death, and only 11% mentioned that the long-term durability of the replacement valve is unknown.

“Adequate presentation of risks and benefits of medical therapies is essential to informed decision making by patients,” the researchers noted. The pointed out that about 78% of adults in the U.S. seek out health information online.

The aortic valve is how freshly oxygenated blood leaves the heart to travel to the rest of the body. When the valve malfunctions it can lead to blood leaking backwards into the left ventricle. Most such malfunctions occur due to congenital defects or due to decay from aging.

Until recently, the valve could only be fixed or replaced during open heart surgery, but the FDA recently approved TAVR, which is a less invasive procedure involving the new valve being threaded through a catheter and expanded into place.

“We were struck by the amount of marketing that surrounded this new procedure,” lead author Mark Neuman, MD, an assistant professor at University of Pennsylvania’s Perelman School of Medicine said in a press release. “Our analysis determined that while hospital websites universally mention the potential benefits of TAVR, they rarely present any information on the procedure’s known risks. Hospitals have an opportunity to encourage appropriate use of this treatment by presenting a more balanced view of both the known risks and benefits of TAVR.”