Quality of life after transcatheter aortic valve implantation and surgical replacement in high-risk elderly patients.
OBJECTIVE
The aim of this study was to compare the quality of life after transcatheter aortic valve implantation (TAVI) and surgical replacement (SAVR) at one year.


METHODS
The study included 45 consecutive high-risk patients (average age 82.0 years; logistic Euroscore 22.3%) with symptomatic severe aortic stenosis allocated to TAVI transfemoral, TAVI transapical using the Edwards-Sapien valve or SAVR with the Edwards Perimount bioprosthesis (n=15 in each). The pre-operative characteristics were similar except for more myocardial infarctions in TAVI. The quality of life was assessed using the standardized EQ-5D questionnaire at baseline and on days 30, 90 and 360. The protocol was approved by the local ethics committee and an informed consent was signed. A total of 7 patients (15.5%) died during follow-up.


RESULTS
At baseline no significant differences in any of the quality-of-life parameters were found except for usual activities described as "best" (46.7% in SAVR vs. 10.0% in TAVI; P=0.002). At 30 and 90 days surviving patients were similar and at 360 days only the anxiety/depression score was "best" in 83.3% SAVR vs. 59.1% (P=0.046). Functional status improved in all patients (NYHA class I-II in 13.3% at baseline vs. 78.9% at 360-days) and the general health median significantly improved in TAVI patients (from 50 to 67; P=0.001) with a positive trend in SAVR patients (P=0.060).


CONCLUSIONS
At one year, the general quality of life of high-risk patients had significantly improved after transcatheter aortic valve implantation with a positive trend in surgically treated patients.
Department of Internal Cardiology Medicine LF MU and FN Brno, Czech Republic.
Petr
P
Kala
Martin
M
Tretina
Martin
M
Poloczek
Jiri
J
Ondrasek
Petr
P
Malik
Petr
P
Pokorny
Jiri
J
Parenica
Jindrich
J
Spinar
Jiri
J
Jarkovsky
Simona
S
Littnerova
Petr
P
Nemec
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000523:psychology / Q000601:surgery*; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods / Q000401:mortality / Q000523:psychology; D006801:Humans; D008297:Male; D011379:Prognosis; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome