Anita W. Asgar MD, FRCPC, FACC Montreal Heart Institute Transcatheter Aortic Valve Implantation: An Example of Patient Centered Decision Making and Focus on QoL Anita W. Asgar MD, FRCPC, FACC Montreal Heart Institute

Aortic Stenosis Degenerative disease of the aortic valve resulting in valvular obstruction and symptoms of shortness of breath and chest pain Requires replacement of the valve to restore function and improve symptoms

Transcatheter Aortic Valve Implantation Current standard of care in high risk patients with aortic stenosis is valve replacement using a percutaneous procedure to implant a new aortic valve by catheter - TAVI

Traditional Medical Approach Disease PATIENT DIAGNOSIS TREATMENT HOSPITAL

Traditional Medical Approach Aortic Stenosis Elderly PATIENT DIAGNOSIS Surgical valve replacement/TAVI HOSPITAL Stay/ convalescence

Patient Centered Approach The IOM (Institute of Medicine) defines patient-centered care as: "Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions."

Traditional Medical Approach Disease PATIENT DIAGNOSIS TREATMENT HOSPITAL Patient Centered Approach

Patient Centered Approach DISEASE DIAGNOSIS TREATMENT HOSPITAL QUALITY OF LIFE

Patient Centered Approach Aortic Stenosis DIAGNOSIS TAVI vs. Surgery Short Hospital Stay Quality of LIFE

Panel Dr. Daniel Jackson, Edwards Lifesciences Dr. Sandra Lauck, St. Paul’s Hospital Dr. Rima Styra, UHN Ms. Judy Duffy, Patient