title: The impact of transcatheter aortic valve implantation on quality of life: results from the German transcatheter aortic valve interventions registry.
abstract: OBJECTIVE
  Transcatheter aortic valve implantation (TAVI) has proven a survival benefit in patients with severe symptomatic aortic stenosis (AS). Recently published data from the German TAVI registry reported a 1-year mortality rate of 19.9 %. However, there are limited data for the effect of TAVI on quality of life (QoL), especially in real life settings.
  
  
  METHODS
  The German TAVI registry was launched to evaluate safety, effectiveness and QoL of TAVI in daily clinical routine. We analyzed health-related QoL, using the EQ-5D questionnaire.
  
  
  RESULTS
  Quality-of-life data were eligible for 460 patients who survived 12 months after TAVI (82.5 ± 6.0 years; 32.2 % men). At baseline, QoL (EQ-5D-index: 0.63 ± 0.26) was markedly depressed, but significantly improved 30 days and 12 months (0.67 ± 0.24; 0.70 ± 0.24; p < 0.0001) after TAVI procedure. In addition, the visual analogue health scale, recording the patient's self-rated health, significantly (p < 0.0001) increased from 42.0 ± 15.9 % at baseline to 57.0 ± 17.2 % (30 days) and 57.7 ± 19.6 % (12 months). A lower EQ-5D-index at baseline, a percutaneous transfemoral/transaxillar TAVI procedure, and indications other than frailty for TAVI were determinants for an improved QoL 1 year after TAVI.
  
  
  CONCLUSIONS
  Among patients with AS, TAVI resulted in meaningful improvements in QoL. This benefit was present shortly after TAVI and maintained for at least 1 year. Different gains in QoL regarding patient-subgroups and determinants for improved QoL could give further impetus for patient selection.
authors.affiliation: Clinic of Cardiology, University Hospital Essen, Essen, Germany. janine.biermann@medman.uni-due.de.|Institute for Health Care Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany. janine.biermann@medman.uni-due.de.
authors.forename: Janine
authors.initials: J
authors.lastname: Biermann
authors.affiliation: Stiftung IHF, Foundation IHF, Institute of Myocardial Infarction Research, Ludwigshafen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Horack
authors.affiliation: Clinic of Cardiology, University Hospital Essen, Essen, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Kahlert
authors.affiliation: Stiftung IHF, Foundation IHF, Institute of Myocardial Infarction Research, Ludwigshafen, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Schneider
authors.affiliation: Department of Medicine II, Cardiology, University Hospital Bonn, Bonn, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Nickenig
authors.affiliation: Stiftung IHF, Foundation IHF, Institute of Myocardial Infarction Research, Ludwigshafen, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Zahn
authors.affiliation: Stiftung IHF, Foundation IHF, Institute of Myocardial Infarction Research, Ludwigshafen, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.affiliation: Clinic of Cardiology, University Hospital Essen, Essen, Germany.
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.affiliation: Institute for Health Care Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Wasem
authors.affiliation: Clinic of Cardiology, University Hospital Essen, Essen, Germany.
authors.forename: Till
authors.initials: T
authors.lastname: Neumann
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D012042:Registries; D011795:Surveys and Questionnaires; D065467:Transcatheter Aortic Valve Replacement / Q000523:psychology* / Q000706:statistics & numerical data; D016896:Treatment Outcome
keywords: EQ-5D; Quality of life; Registry; TAVI; Transcatheter aortic valve implantation