Waikato Hospital’s cardiothoracic department has
identified practical ways to support patients who are making
complex, life-changing decisions about heart valve
surgery.
The department has explored the experiences
of people with rheumatic heart disease who had undergone
valve replacement surgery.
For many patients, surgery
involves choosing between a mechanical valve, which may last
for life but requires ongoing blood-thinning medication, or
a tissue valve, which does not usually require lifelong
medication but may need to be replaced in the
future.
The
Department’s study found patients carefully consider
different outcomes when choosing, with some prioritising
avoiding medication and others wanting to reduce the
likelihood of repeat surgery. Trusted advice from
clinicians, particularly surgeons and cardiologists, played
a central role in decision-making.
Most patients
reported feeling supported in their decision making and said
they would choose the same valve again.
The research
also highlights opportunities to build on existing care,
particularly in supporting patients over the longer term.
These include reinforcing information about medications and
monitoring, supporting follow-up after surgery, and better
understanding barriers that can make it difficult for some
patients to access dental care – which is important for
maintaining heart health.
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The study found some
patients would benefit from clearer understanding of
anticoagulation medicines and follow-up care, with around
one-third reporting they had not seen a cardiologist after
surgery and nearly half not accessing dental care.
The
findings also highlight some of the practical challenges
faced by patients living with rheumatic heart disease,
particularly those in rural or higher-deprivation
communities, where ongoing access to care can be more
difficult.
Consultant Cardiothoracic Surgeon and
Associate Professor Nishith Patel, senior author and
principal investigator on the study, says the findings
provide a valuable evidence base for continuous
improvement.
“Choosing a heart valve is a complex
and highly personal decision. This research will help us
support patients and families through that process, both at
the time of surgery and in the years that
follow.”
The findings are already informing ongoing
work. Researchers are developing a multilingual digital app
to complement conversations between patients, their families
and clinical teams, helping people understand their
treatment options before appointments, revisit information
afterwards, and access support as questions arise during
their long-term care journey.
“Combining these
critical patient insights with clinical expertise, we can
continue to shape services and resources that better support
people living with rheumatic heart
disease.”
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