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Restricted access Mortality After Repeat Revascularization Following PCI or CABG for Left Main Disease: The EXCEL Trial Abnormalities in 3-Dimensional Left Ventricular Mechanics With Anthracycline Chemotherapy Are Associated With Systolic and Diastolic Dysfunction Feasibility and efficacy of the ultrashort side branch dedicated balloon in coronary bifurcation stenting Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease Impact of large periprocedural myocardial infarction on mortality after percutaneous coronary intervention and coronary artery bypass grafting for left main disease: an analysis from the EXCEL trial Left main coronary angioplasty: early and late results of 127 acute and elective procedures Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI Long-term safety and effectiveness of unprotected left main coronary stenting with drug-eluting stents compared with bare-metal stents Unprotected Left Main Disease: Indications and Optimal Strategies for Percutaneous Intervention Coronary Optical Coherence Tomography and Cardiac Magnetic Resonance Imaging to Determine Underlying Causes of Myocardial Infarction With Nonobstructive Coronary Arteries in Women
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PerspectiveVolume 74, Issue 18, November 2019

JOURNAL：J Am Coll Cardiol. Article Link

Aortic Valve Stenosis Treatment Disparities in the Underserved JACC Council Perspectives

W Batchelor, S Anwaruddin, L Ross et al. Keywords: aortic stenosis; health care disparities; outcomes; prevalence; TAVR

ABSTRACT

Underserved minorities make up a disproportionately small subset of patients in the United States undergoing transcatheter and surgical aortic valve replacement for aortic stenosis. The reasons for these treatment gaps include differences in disease prevalence and patient, health care system, and disease-related factors. This has major implications not only for minority patients, but also for other groups who face similar challenges in accessing state-of-the-art care for structural heart disease. The authors propose the following key strategies to address these treatment disparities: 1) implementation of measure-based quality improvement programs; 2) effective culturally competent communication and team-based care; 3) improving patient health care access, education, and effective diagnosis; and 4) changing the research paradigm that creates an innovation pipeline for patients. Only a concerted effort from all stakeholders will achieve equitable and broad application of this and other novel structural heart disease treatment modalities in the future.
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