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Research Letter
July 2016

Palliative Care for Patients With End-Stage Cardiovascular Disease and DevicesA Report From the Palliative Care Working Group of the Geriatrics Section of the American College of Cardiology

Author Affiliations
  • 1Division of Cardiology, Ethics Consultation Service, University of Washington, Seattle
  • 2Division of Cardiology, Department of Medicine, Saint Louis University, St Louis, Missouri
  • 3University of Alabama Birmingham Center for Palliative and Supportive Care, Birmingham
  • 4Birmingham Veterans Affairs Medical Center, Birmingham, Alabama
  • 5Department of Cardiology, Boston Children’s Hospital, Boston, Massachusetts
  • 6Columbia University Medical Center/New York Presbyterian Hospital, New York, New York
  • 7Portland Veterans Affairs Medical Center and Patient-Centered Education and Research, Portland, Oregon
JAMA Intern Med. 2016;176(7):1017-1019. doi:10.1001/jamainternmed.2016.2096

Palliative care has not traditionally been seen as applicable to patients who are candidates for device-based therapies, including transcatheter aortic valve replacement (TAVR) and ventricular assist devices (VADs). However, although improvements in technology, expertise at implanting devices, and patient selection have been made,1 these devices come with a risk of morbid complications that can be particularly deleterious in elderly patients with preexisting comorbidities and impaired baseline functional and/or cognitive status.2 Therefore, we designed a survey of clinicians (physicians, nurses, and advanced practice practitioners) to assess attitudes toward and current status of palliative care in the approach to patients undergoing TAVR and VAD implantation procedures.

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