{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T12:33:32Z","timestamp":1768912412519,"version":"3.49.0"},"reference-count":50,"publisher":"BMJ","issue":"16","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[2017,3,31]]},"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:p>Valvular heart disease (VHD), particularly aortic valve disease, is prevalent with increasing incidence. When surgery is not possible, or when risks outweigh benefits, percutaneous treatment options may offer effective alternatives. However, procedures may not always go as planned, and frail patients or those whose symptoms are caused by other comorbidities may not benefit from valve intervention at all. Significant effort should be made to assess frailty, comorbidities and patient goals prior to intervention. Palliative care (PC) should play a critical role in the care of patients with severe valve disease. PC is specialised medical care that aims to optimise health-related quality of life by managing symptoms and clarifying patient values and goals of care. It should be implemented at the time of diagnosis and continue throughout the disease course. Because of the paucity of studies dedicated to the provision of PC to patients with advanced VHD, further research is needed.<\/jats:p>","DOI":"10.1136\/heartjnl-2016-310538","type":"journal-article","created":{"date-parts":[[2017,8,21]],"date-time":"2017-08-21T02:05:10Z","timestamp":1503281110000},"page":"1233-1237","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Palliative care in end-stage valvular heart disease"],"prefix":"10.1136","volume":"103","author":[{"given":"Jill M","family":"Steiner","sequence":"first","affiliation":[{"name":"Division of Cardiology, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Cooper","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Washington, Seattle, Washington, USA"},{"name":"Division of Cardiology, Harborview Medical Center, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James N","family":"Kirkpatrick","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,7,26]]},"reference":[{"key":"2025100703563007000_103.16.1233.1","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2010.202"},{"key":"2025100703563007000_103.16.1233.2","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-011-9804-7"},{"key":"2025100703563007000_103.16.1233.3","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw229"},{"key":"2025100703563007000_103.16.1233.4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12872-016-0184-8","article-title":"The clinical impact of valvular heart disease in a population-based cohort of subjects aged 80 and older","volume":"16","author":"Rezzoug","year":"2016","journal-title":"BMC Cardiovasc Disord"},{"key":"2025100703563007000_103.16.1233.5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.112.966002"},{"key":"2025100703563007000_103.16.1233.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2006.07.048"},{"key":"2025100703563007000_103.16.1233.7","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.amjcard.2015.03.053","article-title":"Trends of hospitalizations in the United States from 2000 to 2012 of patients >60 years with aortic valve disease","volume":"116","author":"Badheka","year":"2015","journal-title":"Am J Cardiol"},{"key":"2025100703563007000_103.16.1233.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1008232"},{"key":"2025100703563007000_103.16.1233.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.050"},{"key":"2025100703563007000_103.16.1233.10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1103510"},{"key":"2025100703563007000_103.16.1233.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.08.049"},{"key":"2025100703563007000_103.16.1233.12","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.921692"},{"key":"2025100703563007000_103.16.1233.13","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1111\/nyas.12194","article-title":"The Melody\u00ae valve and ensemble\u00ae delivery system for transcatheter pulmonary valve replacement","volume":"1291","author":"McElhinney","year":"2013","journal-title":"Ann N Y Acad Sci"},{"key":"2025100703563007000_103.16.1233.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.02.021"},{"key":"2025100703563007000_103.16.1233.15","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV8I5A95"},{"key":"2025100703563007000_103.16.1233.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2013.02.010"},{"key":"2025100703563007000_103.16.1233.17","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivv053"},{"key":"2025100703563007000_103.16.1233.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.01.028"},{"key":"2025100703563007000_103.16.1233.19","doi-asserted-by":"crossref","first-page":"20","DOI":"10.14797\/mdcj-12-1-20","article-title":"Mitral valve surgery: current minimally invasive and transcatheter options","volume":"12","author":"Ramlawi","year":"2016","journal-title":"Methodist Debakey Cardiovasc J"},{"key":"2025100703563007000_103.16.1233.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.07.065"},{"key":"2025100703563007000_103.16.1233.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.01.047"},{"key":"2025100703563007000_103.16.1233.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.067"},{"key":"2025100703563007000_103.16.1233.23","first-page":"287","article-title":"Study design and rationale of the heterotopic implantation of the Edwards-Sapien XT transcatheter valve in the inferior VEna cava for the treatment of severe tricuspid regurgitation (HOVER) trial","volume":"88","author":"O'Neill","year":"2016","journal-title":"Catheter Cardiovasc Interv"},{"key":"2025100703563007000_103.16.1233.24","doi-asserted-by":"crossref","first-page":"e1837","DOI":"10.4244\/EIJ-D-16-00949","article-title":"Transcatheter treatment of severe tricuspid regurgitation using the edge-to-edge repair technique","volume":"12","author":"Braun","year":"2017","journal-title":"EuroIntervention"},{"key":"2025100703563007000_103.16.1233.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2014.02.003"},{"key":"2025100703563007000_103.16.1233.26","doi-asserted-by":"crossref","first-page":"281","DOI":"10.2174\/1573403X09666131202121750","article-title":"Beyond adding years to life: health-related quality-of-life and functional outcomes in patients with severe aortic valve stenosis at high surgical risk undergoing transcatheter aortic valve replacement","volume":"9","author":"Deutsch","year":"2013","journal-title":"Curr Cardiol Rev"},{"key":"2025100703563007000_103.16.1233.27","doi-asserted-by":"crossref","first-page":"243","DOI":"10.7326\/M13-1316","article-title":"Functional status and quality of life after transcatheter aortic valve replacement: a systematic review","volume":"160","author":"Kim","year":"2014","journal-title":"Ann Intern Med"},{"key":"2025100703563007000_103.16.1233.28","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1202277"},{"key":"2025100703563007000_103.16.1233.29","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq427"},{"key":"2025100703563007000_103.16.1233.30","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25529"},{"key":"2025100703563007000_103.16.1233.31","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1097\/SPC.0000000000000180","article-title":"Transition to palliative care when transcatheter aortic valve implantation is not an option: opportunities and recommendations","volume":"10","author":"Lauck","year":"2016","journal-title":"Curr Opin Support Palliat Care"},{"key":"2025100703563007000_103.16.1233.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.03.061"},{"key":"2025100703563007000_103.16.1233.33","doi-asserted-by":"publisher","DOI":"10.1177\/1474515114520770"},{"key":"2025100703563007000_103.16.1233.34","unstructured":"Miller R . Some valve patients are too sick for TAVI or surgery. Heartwire 2012 http:\/\/www.medscape.com\/viewarticle\/763271."},{"key":"2025100703563007000_103.16.1233.35","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000438"},{"key":"2025100703563007000_103.16.1233.36","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/j.jpainsymman.2016.03.017","article-title":"Emerging collaboration between palliative care specialists and mechanical circulatory support teams: a qualitative study","volume":"52","author":"Sagin","year":"2016","journal-title":"J Pain Symptom Manage"},{"key":"2025100703563007000_103.16.1233.37","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.113.000742","article-title":"Overcoming the barriers to palliative care referral for patients with advanced heart failure","volume":"3","author":"Lindvall","year":"2014","journal-title":"J Am Heart Assoc"},{"key":"2025100703563007000_103.16.1233.38","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2006.10.010"},{"key":"2025100703563007000_103.16.1233.39","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1000678"},{"key":"2025100703563007000_103.16.1233.40","doi-asserted-by":"publisher","DOI":"10.1097\/PPO.0b013e3181f684e5"},{"key":"2025100703563007000_103.16.1233.41","doi-asserted-by":"crossref","first-page":"3884","DOI":"10.1200\/JCO.2001.19.18.3884","article-title":"Quality of life in palliative cancer care: results from a cluster randomized trial","volume":"19","author":"Jordh\u00f8y","year":"2001","journal-title":"J Clin Oncol"},{"key":"2025100703563007000_103.16.1233.42","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1089\/jpm.2016.0330","article-title":"Palliative Care Interventions for patients with Heart failure: a systematic review and meta-analysis","volume":"20","author":"Diop","year":"2017","journal-title":"J Palliat Med"},{"key":"2025100703563007000_103.16.1233.43","doi-asserted-by":"publisher","DOI":"10.1016\/S0195-668X(02)00823-0"},{"key":"2025100703563007000_103.16.1233.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.019"},{"key":"2025100703563007000_103.16.1233.45","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1215620"},{"key":"2025100703563007000_103.16.1233.46","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31824f2173"},{"key":"2025100703563007000_103.16.1233.47","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2010.0747"},{"key":"2025100703563007000_103.16.1233.48","unstructured":"Centers for Medicare and Medicaid Services: National Coverage determination (NCD) for Ventricular Assist Devices. 2015. www.cms.gov\/Regulationsand-AvailableGuidance\/Guidance\/Manuals\/downloads\/ncd103c1_part1.pdf (accessed 12 Dec 2016)."},{"key":"2025100703563007000_103.16.1233.49","unstructured":"The Joint Commission. Certification for ventricular assist devices. 2016 https:\/\/www.jointcommission.org\/certification\/ventricular_assist_device.aspx (accessed 12 Dec 2016)."},{"key":"2025100703563007000_103.16.1233.50","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1089\/jpm.2016.0065","article-title":"Scripted nurse visits: a resource-efficient palliative care model for ventricular assist devices","volume":"19","author":"O'Connor","year":"2016","journal-title":"J Palliat Med"}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/heartjnl-2016-310538","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T10:56:41Z","timestamp":1759834601000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/heartjnl-2016-310538"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,26]]},"references-count":50,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2017,7,26]]},"published-print":{"date-parts":[[2017,8]]}},"alternative-id":["10.1136\/heartjnl-2016-310538"],"URL":"https:\/\/doi.org\/10.1136\/heartjnl-2016-310538","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"value":"1355-6037","type":"print"},{"value":"1468-201X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7,26]]}}}