title: Assessment of quality of life in patients after surgical and transcatheter aortic valve replacement.
abstract: OBJECTIVE
  Transcatheter aortic valve implantation (TAVI) and minimally invasive aortic valve replacement (mini-thoracotomy, mini-sternotomy, MIAVR) have become an appealing alternative to conventional surgical (SAVR) treatment of severe aortic stenosis (AS) in high-risk patients.
  
  
  BACKGROUND
  Aim of the study was to evaluate the quality of life (QoL) in patients with AS and treated with transfemoral TAVI, SAVR, mini-thoracotomy and mini-sternotomy.
  
  
  METHODS
  One hundred and seventy-three patients with symptomatic AS were enrolled in 2011-2013. TAVI group consisted of 39 patients (22.5%), mini-sternotomy was performed in 44 patients (25.5%), mini-thoracotomy in 50 (29%), and AVR in 40 patients (23%). QoL was assessed perioperatively, 12 and 24 months after aortic valve replacement (AVR) by Minnesota Living with Heart Failure Questionnaire (MLHFQ) and EQ-5D-3L.
  
  
  RESULTS
  Median follow-up was 583.5 (IQR: 298-736) days. Improvement of health status after procedure in comparison with pre-operative period was significantly more often reported after TAVI in perioperative period (90.3%; P = 0.004) and 12 months after procedure (100%, P = 0.02). Global MLHFQ, physical and emotional dimension score at 30-day from AVR presented significant improvement after TAVI in comparison with surgical methods (respectively: 8.3(±8.6), P = 0.003; 4.1(±5.9), P = 0.01; 1.5(±2.6), P = 0.005). Total MLHFQ score was significantly lower (better outcome) in TAVI patients 1 year after procedure (4.8(±6.8), P = 0.004), no differences in somatic and emotional component were found. No differences were found in MLHFQ score 24 months after AVR. Data from EQ-D5-3L questionnaire demonstrated significant improvement of QoL at 30-day follow-up after TAVI in comparison with surgical methods (1.2(±1.7), P = 0.0008).
  
  
  CONCLUSIONS
  TAVI improves QoL in perioperative and 12 months observation in comparison with mini-thoracotomy, mini-sternotomy and SAVR. Improvement in QoL was obtained in both generic and disease specific questionnaires. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Interventional Cardiology at University Hospital, Jagiellonian University Medical College in Krakow, Poland. tomek.tokarek@gmail.com.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Tokarek
authors.affiliation: Department of Interventional Cardiology at University Hospital, Jagiellonian University Medical College in Krakow, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Siudak
authors.affiliation: 2nd Department of Cardiology, Jagiellonian University Medical College in Krakow, Poland.
authors.forename: Artur
authors.initials: A
authors.lastname: Dziewierz
authors.affiliation: Department of Cardiovascular Surgery and Transplantology at University Hospital, Jagiellonian University Medical College in Kraków, Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Sobczyński
authors.affiliation: 2nd Department of Cardiology, Jagiellonian University Medical College in Krakow, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Zasada
authors.affiliation: 2nd Department of Cardiology, Jagiellonian University Medical College in Krakow, Poland.
authors.forename: Danuta
authors.initials: D
authors.lastname: Sorysz
authors.affiliation: Department of Interventional Cardiology at University Hospital, Jagiellonian University Medical College in Krakow, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Olszewska-Wityńska
authors.affiliation: Department of Interventional Cardiology at University Hospital, Jagiellonian University Medical College in Krakow, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Bryniarski
authors.affiliation: Department of Interventional Cardiology at University Hospital, Jagiellonian University Medical College in Krakow, Poland.
authors.forename: Agata
authors.initials: A
authors.lastname: Krawczyk-Ożóg
authors.affiliation: Department of Interventional Cardiology at University Hospital, Jagiellonian University Medical College in Krakow, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Żabówka
authors.affiliation: Department of Cardiovascular Surgery and Transplantology at University Hospital, Jagiellonian University Medical College in Kraków, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Sadowski
authors.affiliation: Department of Interventional Cardiology at University Hospital, Jagiellonian University Medical College in Krakow, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Dudek
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D004644:Emotions; D005260:Female; D006304:Health Status; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland; D011788:Quality of Life; D020127:Recovery of Function; D012720:Severity of Illness Index; D056346:Sternotomy; D011795:Surveys and Questionnaires; D013908:Thoracotomy; D013997:Time Factors; D016896:Treatment Outcome
keywords: TAVI; aortic stenosis; mini-sternotomy; mini-thoracotomy