# Palliative Care for High-Risk TAVR Patients: The Impact of Multimorbidity

> **NIH NIH K23** · TUFTS MEDICAL CENTER · 2021 · $188,204

## Abstract

Project Summary
Moderate to severe valvular heart disease is a major cause of morbidity and mortality for the aging U.S.
population and transcatheter aortic valve replacement (TAVR) has revolutionized care for older adults with
symptomatic aortic stenosis and elevated pre-procedural risk. Not all patients benefit from treatment and one
third of TAVR patients remain severely symptomatic or die 1 year after treatment. Comorbid conditions are
likely the major determinants of benefit following TAVR since half of all deaths following treatment are due to
non-cardiac causes. No studies have explored the impact of multiple chronic conditions (MCC) on patient-
centered outcomes following TAVR, nor studied the benefits of palliative care (PC) for high-risk patients. This
proposal addresses knowledge gaps related to the significance of MCC and the use of early PC for high-risk
cardiovascular patients. Aim 1 of this research will determine the impact of MCC on short-term quality of life
(QOL), mortality, and PC use for high-risk TAVR patients enrolled in the Transcatheter Valve Therapy
Registry. Aim 2 will use focus groups to characterize the care needs of high-risk older adults treated with
TAVR. Aim 3 is a feasibility study of adding early PC to standard care for high-risk TAVR patients with MCC.
The pilot trial will determine if PC can be introduced early after TAVR for patients likely to have PC needs. The
primary outcome is short-term QOL as measured by Kansas City Cardiomyopathy Questionaire. Interventions
for older adults with advanced VHD are rapidly increasing both in scope and availability. Completion of the
aims will determine whether MCC for high-risk TAVR patients negatively impacts patient-centered outcomes
and whether MCC can be used to identify patients who are likely to benefit from PC. Thus, this research aligns
with the priorities of the National Institute on Aging to improve clinical care for patients with MCC. This
mentored award will support essential training in PC research methods, registry analytics, implementation
science and clinical trial management.

## Key facts

- **NIH application ID:** 10143151
- **Project number:** 5K23AG055667-04
- **Recipient organization:** TUFTS MEDICAL CENTER
- **Principal Investigator:** Benjamin Seth Wessler
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $188,204
- **Award type:** 5
- **Project period:** 2018-08-15 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10143151

## Citation

> US National Institutes of Health, RePORTER application 10143151, Palliative Care for High-Risk TAVR Patients: The Impact of Multimorbidity (5K23AG055667-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10143151. Licensed CC0.

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