Quality of life improvement is maintained up to two years after transcatheter aortic valve implantation in high-risk surgical candidates.
OBJECTIVE
The aim of the study was to investigate the changes in quality of life (QoL) following transcatheter aortic valve implantation (TAVI) up to two years' follow-up.


RESULTS
One hundred consecutive patients (46 females, mean age 79.7 ± 6.1 years) with at least two years' follow-up who underwent TAVI in our institution, between November 2007 and September 2009, were enrolled in this study. Peak and mean aortic gradients were 87.8 ± 25.8 mmHg and 53.3 ± 15.4 mmHg, respectively. Mean log EuroSCORE was 27.9 ± 15.9. Patients had multiple comorbidities. All patients underwent a standardised prospective screening pathway, including QoL evaluation with the 36-item short-form health survey (SF-36v2(®)) and the Minnesota Living with Heart Failure Questionnaires (MLHFQ). The scores obtained preoperatively were compared with those obtained at two years' follow-up. An Edwards SAPIEN valve (Edwards Lifesciences, Irvine, CA, USA) was implanted in 67 patients (55 transfemoral and 12 transapical) and a CoreValve (Medtronic, Inc., Minneapolis, MN, USA) was implanted in 33 patients (26 transfemoral and seven transaxillary). Thirty-day mortality was 4%. Actuarial survival was 80.6 ± 4.1%, 72.6 ± 4.7% and 63.2 ± 6.3% at one, two and three years, respectively. Mean SF36-physical improved from 31.9 ± 8.8 to 51.5 ± 9.5 (p<0.0001) and SF36-mental improved from 44.7 ± 11.6 to 49.5 ± 8.6 (p=0.0002). Mean MLHFQ decreased from 41.5 ± 14.5 to 15.9 ± 13.7 (p<0.0001). QoL score changes were not influenced by age or comorbidities.


CONCLUSIONS
TAVI in high-risk surgical candidates is associated with favourable short and long-term survival and with improvement of QoL up to two years after the procedure.
Cardiothoracic Department, San Raffaele Scientific Institute, Milan, Italy. taramasso.maurizio@hsr.it
Maurizio
M
Taramasso
Azeem
A
Latib
Micaela
M
Cioni
Paolo
P
Denti
Nicola
N
Buzzatti
Cosmo
C
Godino
Alaide
A
Chieffo
Ottavio
O
Alfieri
Antonio
A
Colombo
Francesco
F
Maisano
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006306:Health Surveys; D006349:Heart Valve Diseases / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D015996:Survival Rate; D016896:Treatment Outcome