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Assessment of quality of life in patients after surgical and transcatheter aortic valve replacement
Author(s) -
Tokarek Tomasz,
Siudak Zbigniew,
Dziewierz Artur,
Sobczyński Robert,
Zasada Wojciech,
Sorysz Danuta,
OlszewskaWityńska Katarzyna,
Bryniarski Krzysztof,
KrawczykOżóg Agata,
Żabówka Anna,
Sadowski Jerzy,
Dudek Dariusz
Publication year - 2016
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26400
Subject(s) - medicine , aortic valve replacement , thoracotomy , stenosis , perioperative , quality of life (healthcare) , surgery , aortic valve , median sternotomy , cardiology , nursing
Objectives Transcatheter aortic valve implantation (TAVI) and minimally invasive aortic valve replacement (mini‐thoracotomy, mini‐sternotomy, MIAVR) have become an appealing alternative to conventional surgical (SAVR) treatment of severe aortic stenosis (AS) in high‐risk patients. Background Aim of the study was to evaluate the quality of life (QoL) in patients with AS and treated with transfemoral TAVI, SAVR, mini‐thoracotomy and mini‐sternotomy. Methods One hundred and seventy‐three patients with symptomatic AS were enrolled in 2011–2013. TAVI group consisted of 39 patients (22.5%), mini‐sternotomy was performed in 44 patients (25.5%), mini‐thoracotomy in 50 (29%), and AVR in 40 patients (23%). QoL was assessed perioperatively, 12 and 24 months after aortic valve replacement (AVR) by Minnesota Living with Heart Failure Questionnaire (MLHFQ) and EQ‐5D‐3L. Results Median follow‐up was 583.5 (IQR: 298–736) days. Improvement of health status after procedure in comparison with pre‐operative period was significantly more often reported after TAVI in perioperative period (90.3%; P = 0.004) and 12 months after procedure (100%, P = 0.02). Global MLHFQ, physical and emotional dimension score at 30‐day from AVR presented significant improvement after TAVI in comparison with surgical methods (respectively: 8.3(±8.6), P = 0.003; 4.1(±5.9), P = 0.01; 1.5(±2.6), P = 0.005). Total MLHFQ score was significantly lower (better outcome) in TAVI patients 1 year after procedure (4.8(±6.8), P = 0.004), no differences in somatic and emotional component were found. No differences were found in MLHFQ score 24 months after AVR. Data from EQ‐D5‐3L questionnaire demonstrated significant improvement of QoL at 30‐day follow‐up after TAVI in comparison with surgical methods (1.2(±1.7), P = 0.0008). Conclusions TAVI improves QoL in perioperative and 12 months observation in comparison with mini‐thoracotomy, mini‐sternotomy and SAVR. Improvement in QoL was obtained in both generic and disease specific questionnaires. © 2016 Wiley Periodicals, Inc.