Improvement of physical and mental health after transfemoral transcatheter aortic valve implantation.
OBJECTIVE
Transcatheter aortic valve implantation (TAVI) has emerged as a treatment alternative to surgical aortic valve replacement in elderly high-risk patients with symptomatic severe aortic stenosis. In this patient population, rapid improvement or restoration of quality of life (QoL) is at least as important as improved clinical outcomes. The purpose of the present study was to assess changes in QoL in response to TAVI.


RESULTS
Between August 2007 and August 2010, 62 patients (39% females, age 83 ± 5 years) underwent TAVI and were included in this QoL study. QoL was impaired at baseline and improved in all components of physical and mental health at nine months of follow-up: physical functioning (37.0 to 59.0, p<0.0001), physical role functioning (18.3 to 49.1, p<0.0001), general health (55.9 to 64.9, p=0.001), vitality (40.7 to 51.3, p<0.001), social functioning (67.4 to 76.8, p=0.049), emotional functioning (52.0 to 75.8, p<0.001) and mental health (66.6 to 75.8, p=0.05). The subscale bodily pain (60.7 to 70.4, p=0.058) showed a strong trend to improvement, but failed to reach statistical significance. Besides changes in health-related QoL, TAVI significantly improved symptoms (NYHA class 2.6 ± 0.8 to 1.4 ± 0.6, p<0.0001).


CONCLUSIONS
TAVI leads to rapid and sustained restoration of all aspects of mental and physical health and effectively alleviates symptoms.
Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, University of Bern, Switzerland.
Stefan
S
Stortecky
Valerie
V
Schmid
Stephan
S
Windecker
Alexander
A
Kadner
Thomas
T
Pilgrim
Lutz
L
Buellesfeld
Ahmed A
AA
Khattab
Peter
P
Wenaweser
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery; D023381:Endpoint Determination; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006304:Health Status; D006306:Health Surveys; D006349:Heart Valve Diseases / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008603:Mental Health; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome