Quality of life in octogenarians after valve replacement due to aortic stenosis. A prospective comparison with younger patients.
BACKGROUND
Results of aortic valve surgery in octogenarians have been evaluated as event-free survival. However, little attention has been given to quality of life aspects.


METHODS
Thirty-two consecutive patients, mean age 83 +/- 2 years, undergoing valve replacement due to aortic stenosis, were compared to 30 patients, mean age 71 +/- 3 years, undergoing the same procedure. Mortality, morbidity and quality of life were studied. An interview was performed before surgery and 3 and 12 months postoperatively. The questionnaire contained items related to self-rated health, symptoms, physical ability, sleep disturbances and social and emotional functioning.


RESULTS
Pre-operatively the older patient group was in a worse condition with a higher NYHA functional class and a more pronounced cardiomegaly. They had more cardiac symptoms and were more depressed. The control group had a higher score for physical ability and rated their quality of life as better. Postoperatively there was a higher early mortality rate in the octogenarians (9% vs 0%; ns). After 3 months, improvement of functional status and relief of symptoms was observed in both groups. Physical ability improved and the depression score decreased significantly in both groups. Self-rated health and quality of life improved. One year after valve replacement the improvement in quality of life was of a similar magnitude in the two groups.


CONCLUSIONS
Following aortic valve replacement, octogenarians, despite a more compromised pre-operative status showed an improvement in symptomatology, physical ability and general well being, of a similar magnitude to that of the younger patients group. These findings lend further support to the recommendation that valve replacement should be performed in octogenarians with symptomatic aortic stenosis.
Olsson
M
M
Department of Cardiology, Karolinska Hospital, Stockholm, Sweden.
Janfjäll
H
H
Orth-Gomér
K
K
Undén
A
A
Rosenqvist
M
M
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D009017:Morbidity; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D015996:Survival Rate; D016896:Treatment Outcome