The impact of coronary artery disease on the quality of life of patients undergoing aortic valve replacement

Of 415 patients, 200 undergoing aortic valve replacement (AVR) and 215 undergoing AVR in combination with myocardial revascularization [coronary artery bypass grafting (CABG)], had complete preoperative health-related quality of life (HRQOL) data. From this group, 224 patients had a follow-up of one year. To assess HRQOL, the EuroQol instrument was used. The EQ-5D index score was calculated, based on separate scores from five health domains, to express the global health status of the patient. The EQ visual analogue scale (VAS) was used to describe patients' subjective HRQOL. At baseline, the EQ-5D showed no significant differences between the two groups. The EQ-VAS score, however, was statistically significantly lower in the AVR+CABG patients (P=0.031). At one year postoperatively, both groups showed a statistically significant increase in the EQ-VAS (P=0.001 and P=0.001, respectively) and the EQ-5D (P=0.001 and P=0.001, respectively). This increase, however, could only be ascertained for the domain 'pain/discomfort' (P=0.001) in the AVR group, and for 'mobility' (P=0.018), 'usual activities' (P=0.001), 'pain/discomfort' (P=0.001) and 'anxiety/depression' (P=0.001) in the AVR+CABG group. At baseline, coronary artery disease had a negative influence on the patients' HRQOL, especially on the EQ-VAS. Postoperatively, all patients experienced significantly better HRQOL. However, the patients undergoing combined surgery experienced more benefit from their operation.