Transcatheter Aortic Valve Implantation for Aortic Stenosis: A Rapid Qualitative Review

Key Message

When deciding whether to undergo TAVI, patients reflected on the impact of their symptoms on their daily lives. Patients expected TAVI would afford them a longer life and a return to the activities that gave their lives meaning. They considered their prior health care experiences and those of their family members and friends, and how interventions had led to improved health. Although some chose to make the decision alone, many patients involved close family and adult children in their decision making. Trust in their physician helped patients feel confident in the decision-making process and their choice, and reduced worries about risk. Patients can encounter logistical challenges when accessing TAVI through the need to travel to specialist centres in urban areas. Patients described the importance of having a caregiver available for them at discharge and during the recovery period. Patients described experiencing a ‘new lease on life’ when they had rapid recovery and improvement in symptoms post-TAVI. But patients who had long hospital stays, and/or slow or no symptom improvement from TAVI struggled to reconcile their expectations with their actual experience. Figuring prominent amongst those whose expectations were not met was the way that, post-TAVI, the impact of comorbidities on their health and lives became clearer. From the limited information available on health care providers’ perspectives, physicians appear to value TAVI for its short recovery time but expressed concerns about the use of TAVI for younger patients due to the lack of long-term data on the durability of valves.