Long-term quality of life improvement after transcatheter aortic valve implantation

Am Heart J. 2011 Aug;162(2):232-7. doi: 10.1016/j.ahj.2011.06.004. Epub 2011 Jul 20.

Abstract

Background: Transcatheter aortic valve implantation (TAVI) is a novel therapeutic option for severe aortic stenosis in old patients with high surgical risk. The aim of this study was to assess changes in quality of life (QoL) along with functional status and late survival after this procedure.

Methods: Thirty-six consecutive patients (80.5 ± 5.9 years, 21 men and 15 women) with a logistic Euroscore of 29.7 ± 13.7 underwent TAVI using the 18-Fr CoreValve prosthesis. Aortic valve prosthesis was inserted retrograde using a femoral or a subclavian arterial approach. QoL was evaluated by administering the Short Form 36 (SF-36) tool and the shorter SF-12 version 2 (SF-12v2) questionnaires before and 1-year after TAVI.

Results: TAVI was successfully performed in all patients. The estimated 1-year overall survival rate using Kaplan-Meier method was 68%. One-year follow-up also showed a marked improvement in echocardiographic parameters (peak gradient 76.2 ± 26.1 vs 15.4 ± 7.8 mm Hg, P < .001; aortic valve area 0.7 ± 0.1 vs 2.6 ± 2.7 cm(2), P < .001) with a significant change in New York Heart Association class (3 ± 0.7 vs 1.2 ± 0.4, P < .001). Both preprocedural summary SF-36 and SF-12v12 physical and mental scores showed a significant improvement 1 year after TAVI (21.6 vs 46.7, P < .001; 42.9 vs 55.2, P < .001; 22 vs 48.9, P < .001; 43.3 vs 52.2, P < .001, respectively).

Conclusions: Our results show a marked 1-year clinical benefit in functional status and physical and mental health in patients who underwent TAVI.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Valve Stenosis / psychology
  • Aortic Valve Stenosis / surgery*
  • Cardiac Catheterization / methods*
  • Cardiac Catheterization / psychology
  • Female
  • Follow-Up Studies
  • Heart Valve Prosthesis Implantation / methods*
  • Heart Valve Prosthesis Implantation / psychology
  • Humans
  • Male
  • Middle Aged
  • Postoperative Period
  • Quality of Life*
  • Retrospective Studies
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome