title: Quality of life and prosthetic aortic valve selection in non-elderly adult patients.
abstract: This study assesses quality of life in relation to prosthetic aortic valve selection and preferences for shared decision-making among non-elderly adult patients after aortic valve replacement (AVR).
  
  
  
  A single-centre consecutive cohort of 497 AVR patients who underwent AVR between the age of 18 and 60 years was cross-sectionally surveyed 1-10 years after AVR. Health-related quality of life (Short-Form Health Survey, SF-36), valve-specific quality of life, patient experience with and preferences for involvement and final decision in prosthetic valve selection were investigated.
  
  
  
  Two-hundred and forty patients (48%) responded. The median age was 57 years (range 26-70). Compared with the general age-matched Dutch population, AVR patients reported worse physical health, but better mental health. Biological valve recipients reported lower general health than mechanical valve recipients. Mechanical valve recipients had more doubts about the decision to undergo surgery, were more bothered by valve sound, the frequency of doctor visits and blood tests, and possible bleeding, but were less afraid of a possible reoperation. Eighty-nine percent were of the opinion that it is important to be involved in prosthetic valve selection, whereas 64% agreed that they actually had been involved. A better patient experience with involvement in prosthetic valve selection was associated with better mental health (P = 0.036).
  
  
  
  Given the observed suboptimal patient involvement in prosthetic valve selection, the broad patient support for shared decision-making, and the positive association between patient involvement in prosthetic valve selection and mental health, tools to support shared decision-making would be useful in the setting of heart valve replacement.
authors.affiliation: Department of Cardio-Thoracic Surgery, Erasmus MC, Rotterdam, Netherlands.
authors.forename: Nelleke M
authors.initials: NM
authors.lastname: Korteland
authors.affiliation: Department of Cardio-Thoracic Surgery, Erasmus MC, Rotterdam, Netherlands.
authors.forename: Derya
authors.initials: D
authors.lastname: Top
authors.affiliation: Department of Public Health, Erasmus MC, Rotterdam, Netherlands.
authors.forename: Gerard J J M
authors.initials: GJ
authors.lastname: Borsboom
authors.affiliation: Department of Cardiology, Erasmus MC, Rotterdam, Netherlands.
authors.forename: Jolien W
authors.initials: JW
authors.lastname: Roos-Hesselink
authors.affiliation: Department of Cardio-Thoracic Surgery, Erasmus MC, Rotterdam, Netherlands.
authors.forename: Ad J J C
authors.initials: AJ
authors.lastname: Bogers
authors.affiliation: Department of Cardio-Thoracic Surgery, Erasmus MC, Rotterdam, Netherlands j.j.m.takkenberg@erasmusmc.nl.
authors.forename: Johanna J M
authors.initials: JJ
authors.lastname: Takkenberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: Aortic valve replacement; Quality of life; Shared decision-making