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Research Letter |

Advance Directives of Patients With High-Risk or Inoperable Aortic Stenosis

Vuyisile T. Nkomo, MD, MPH1; Rakesh M. Suri, MD, DPhil2; Sorin V. Pislaru, MD, PhD1; Kevin L. Greason, MD2; Verghese Mathew, MD1,3; Charanjit S. Rihal, MD1; Paul S. Mueller, MD, MPH4
[+] Author Affiliations
1Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
2Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota
3Department of Radiology, Mayo Clinic, Rochester, Minnesota
4Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
JAMA Intern Med. 2014;174(9):1516-1518. doi:10.1001/jamainternmed.2014.3453.
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Severe, symptomatic aortic stenosis (AS) is associated with high morbidity and mortality rates, which can be reduced with surgical aortic valve replacement and transcatheter aortic valve replacement (TAVR).1,2 However, patients who have these procedures may experience procedure-related morbidity (eg, stroke, vascular complications, and arrhythmia) and death.2 Thus, regardless of treatment approach, patients with severe AS should engage in advance care planning, which includes documenting their end-of-life values, goals, and preferences in an advance directive (AD). Advance directives are written instructions for future health care in the event that a patient loses decision-making capacity. In this study, we determined the prevalence and contents of ADs of patients with symptomatic severe AS and high surgical risk or inoperable status.

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