Palliative care in end-stage valvular heart disease

The ESC Guidelines represent the views of the ESC and were produced after careful consideration of the scientific and medical knowledge and the evidence available at the time of their dating. The ESC is not responsible in the event of any contradiction, discrepancy and/or ambiguity between the ESC Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of health care or therapeutic strategies. Health professionals are encouraged to take the ESC Guidelines fully into account when exercising their clinical judgment as well as in the determination and the implementation of preventive, diagnostic or therapeutic medical strategies. However, the ESC Guidelines do not override in any way whatsoever the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient's health condition and in consultation with that patient and the patient's caregiver where appropriate and/or necessary. Nor do the ESC Guidelines exempt health professionals from taking careful and full consideration of the relevant official updated recommendations or guidelines issued by the competent public health authorities in order to manage each patient's case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional's responsibility to verify the applicable rules and regulations relating to drugs and medical devices at the time of prescription.

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“…However, care is futile when no life prolongation or symptom relief is anticipated. 70 ESC/EACTS Guidelines…”

Section: Patient-related Aspectsmentioning

confidence: 99%

2021 ESC/EACTS Guidelines for the management of valvular heart disease

Vahanian¹,

Beyersdorf²,

Praz³

et al. 2022

EuroIntervention

570

581

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“…16 There are existing position papers and reviews related to the delivery of palliative care in heart disease patients. 17,18 The primary focus of this position paper is the extended process of ACP rather than palliative or end-of-life care.…”

Section: Terminology and Concepts Related To Advance Care Planningmentioning

confidence: 99%

Recommendations for advance care planning in adults with congenital heart disease: a position paper from the ESC Working Group of Adult Congenital Heart Disease, the Association of Cardiovascular Nursing and Allied Professions (ACNAP), the European Association for Palliative Care (EAPC), and the International Society for Adult Congenital Heart Disease (ISACHD)

Schwerzmann

Goossens

Gallego

et al. 2020

European Heart Journal

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Survival prospects in adults with congenital heart disease (CHD), although improved in recent decades, still remain below expectations for the general population. Patients and their loved ones benefit from preparation for both unexpected and predictable deaths, sometimes preceded by a prolonged period of declining health. Hence, advance care planning (ACP) is an integral part of comprehensive care for adults with CHD. This position paper summarizes evidence regarding benefits of and patients’ preferences for ACP and provides practical advice regarding the implementation of ACP processes within clinical adult CHD practice. We suggest that ACP be delivered as a structured process across different stages, with content dependent upon the anticipated disease progression. We acknowledge potential barriers to initiate ACP discussions and emphasize the importance of a sensitive and situation-specific communication style. Conclusions presented in this article reflect agreed expert opinions and include both patient and provider perspectives.

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“…For this reason, the members of a PC team, or at least a PC specialist, should be included in the core Heart Team. 64 In such cases, PC can include assistance in the decision -making process, communicating alternative, noninterventional treatment options, ACP, or delivering care for the dying in the case of serious complications. 64,65 Further studies are needed to assess the impact, efficacy, and safety of specific PC interventions in the population of patients with valvular heart disease.…”

Section: Elements Of Palliative Care Interventionsmentioning

confidence: 99%