Health-related quality of life after transcatheter aortic valve implantation in elderly patients with severe aortic stenosis.
BACKGROUND
Severe aortic stenosis may affect both normal daily living and survival. Transcatheter aortic valve implantation (TAVI) has become an appropriate alternative to surgery for elderly patients with high surgical risk, and it results in improved survival in this population.


OBJECTIVE
To describe health-related quality of life (QoL) before, and at 1 and 6 months after TAVI.


METHODS
Cardiovascular Department, Toulouse University Hospital, France.


METHODS
One hundred sixty-four consecutive patients with at least 6 months follow-up who underwent TAVI in our institution between February 2009 and June 2011 were enrolled in the study. Of this population, 73 (mean age: 82.3 ± 7.3 years, 56% men) completed QoL assessment using the EuroQOL Five Dimensions (EQ-5D) questionnaire and a visual analogue scale at baseline, and at 1 and 6 months. At each visit, medical data and New York Heart Association functional class were collected.


RESULTS
The median preprocedure EQ-5D index value (interquartile range) was 0.66 (range, 0.36-0.78) showing severely impaired QoL in almost all patients. Significant improvement occurred from baseline to 1 month of follow-up in EQ-5D index value [0.73 (range, 0.59-0.79)] and this was maintained at 0.73 (range, 0.62-0.81) at 6 months. The improvement was significant for 3 dimensions of the EQ-5D score at the 6-month follow-up: usual activities in 43.8% of patients (P < .001); anxiety/depression in 37% (P < .001) and pain/discomfort in 28.8% (P < .05). Mean New York Heart Association class improved significantly from 3.24 at baseline to 2.04 at 1 month and 1.89 at 6 months.


CONCLUSIONS
In high-risk patients with severe aortic stenosis, QoL and health status improved substantially at 1 month and improvement persisted 6 months after TAVI.
Gérontopôle, Service de Médecine Interne Gériatrique du Pr B. Vellas, CHU Toulouse Hôpital Casselardit, Toulouse, France. Electronic address: elmalem.s@chu-toulouse.fr.
Sophie
S
Elmalem
Pôle Cardiovasculaire et Métabolique, CHU Hopital Rangueil, Toulouse, France.
Nicolas
N
Dumonteil
Pôle Cardiovasculaire et Métabolique, CHU Hopital Rangueil, Toulouse, France.
Bertrand
B
Marcheix
Gérontopôle, Service de Médecine Interne Gériatrique du Pr B. Vellas, CHU Toulouse Hôpital Casselardit, Toulouse, France.
Olivier
O
Toulza
Gérontopôle, Service de Médecine Interne Gériatrique du Pr B. Vellas, CHU Toulouse Hôpital Casselardit, Toulouse, France; Inserm U1027, Toulouse, France.
Bruno
B
Vellas
Pôle Cardiovasculaire et Métabolique, CHU Hopital Rangueil, Toulouse, France.
Didier
D
Carrie
Gérontopôle, Service de Médecine Interne Gériatrique du Pr B. Vellas, CHU Toulouse Hôpital Casselardit, Toulouse, France; Inserm U1027, Toulouse, France.
Fati
F
Nourhashemi
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006328:Cardiac Catheterization; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D064232:Visual Analog Scale
Transcatheter aortic valve implantation; elderly; quality of life