title: Quality of life improvement at midterm follow-up after transcatheter aortic valve implantation.
abstract: BACKGROUND
  Transcatheter aortic valve implantation (TAVI) techniques have been presenting good procedural success and favorable clinical outcomes. However, optimal management of aortic valve disease in elderly patients depends on quality of life (QoL) improvement. In this study we aimed to evaluate changes in QoL in patients referred for TAVI.
  
  
  RESULTS
  Prospective analysis of 74 consecutive patients (34 male), aged 81.6 ± 8 years with symptomatic severe aortic valve stenosis (AS) ineligible for conventional aortic valve replacement, referred to TAVI in one tertiary center. For the assessment of QoL, the Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used before the procedure and at 6.5 months. The mortality was 9.5% at 30 days and 20.2% at 6.5 months follow-up. Fifty three (71.6%) patients completed MLHFQ at baseline and at follow-up. All patients showed good hemodynamic results and no signs of prosthesis dysfunction were observed on transthoracic echocardiography. The New York Heart Association (NYHA) class (2.9 ± 0.4 to 1.4 ± 0.7; p<0.001), and the MLHFQ scores [overall (37.0 ± 14.7 vs. 14.4 ± 10.1; p<0.001), physical dimension (23.2 ± 9.5 vs. 8.6 ± 5.9; p<0.001) and emotional dimension (5.4 ± 4.2 vs. 2.6 ± 3.0; p<0.001)] were significantly improved 6.5 months after TAVI. Patients with peripheral vascular disease (PVD) had an inferior improvement in QoL caused by a lower enhancement in physical dimension MLHFQ score (mean difference: -17.0 ± 10.2 vs. -10.1 ± 11.5; p=0.036).
  
  
  CONCLUSIONS
  TAVI significantly improves symptoms and QoL in patients with severe AS and high surgical risk. Patients with PVD might be expected to have a less impressive improvement in QoL after TAVI.
authors.affiliation: Cardiovascular Institute, Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Gonçalves
authors.forename: Pedro
authors.initials: P
authors.lastname: Marcos-Alberca
authors.forename: Carlos
authors.initials: C
authors.lastname: Almeria
authors.forename: Gisela
authors.initials: G
authors.lastname: Feltes
authors.forename: Rosa Ana
authors.initials: RA
authors.lastname: Hernández-Antolín
authors.forename: Enrique
authors.initials: E
authors.lastname: Rodríguez
authors.forename: José Luis
authors.initials: JL
authors.lastname: Rodrigo
authors.forename: Javier
authors.initials: J
authors.lastname: Cobiella
authors.forename: Luis
authors.initials: L
authors.lastname: Maroto
authors.forename: José C Silva
authors.initials: JC
authors.lastname: Cardoso
authors.forename: Carlos
authors.initials: C
authors.lastname: Macaya
authors.forename: José Luis
authors.initials: JL
authors.lastname: Zamorano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D006328:Cardiac Catheterization; D015331:Cohort Studies; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome