Health-related quality-of-life after transapical transcatheter aortic valve implantation.
OBJECTIVE
Transcatheter aortic valve implantation (TA-TAVI) is a well-established treatment for aortic valve stenosis in high-risk patients and indications have been continuously expanding to also include intermediate-risk patients. However, in low-risk patients, experiences are still sparse and although clinical outcomes have been shown favorable results, HRQoL has remained unexplored. The aim of this report was to describe the long-term health-related quality-of-life (HRQoL) in low-risk patients randomized to TA-TAVI or surgical aortic valve replacement (SAVR).


METHODS
In a prospective, randomized trial, patients with aortic valve stenosis were randomized to either TA-TAVI or SAVR. TA-TAVI was performed through a mini thoracotomy with the introduction of prosthesis via the apex of the heart and antegradely advancement over the pre-dilated native valve. SAVR was performed during cardiopulmonary bypass with resection of the native valve and replacement with a prosthesis valve through a median sternotomy. Afterwards, patients were followed yearly with echocardiography and HRQoL assessment.


RESULTS
A total of 58 patients were included; 29 patients for TA-TAVI and 29 patients for SAVR. The only difference in HRQoL was found in the physical component summary after 1 year; 44 ± 9 in the TA-TAVI group compared with 36 ± 9 in the SAVR group, p = .03. There were no differences in any of the remaining timepoints in neither physical nor mental component summary, p = .19 and p = .98, respectively, and there were no differences in survival during the 5 years.


CONCLUSIONS
In low-risk patients with aortic valve stenosis undergoing TA-TAVI, no differences appeared in HRQoL compared with SAVR during a 5-year follow-up period.
a Deparment of Cardiothoracic & Vascular Surgery , Aarhus University Hospital , Aarhus , Denmark.|b Deparment of Clinical Medicine , Aarhus University Hospital , Aarhus , Denmark.
Christian E
CE
Rex
a Deparment of Cardiothoracic & Vascular Surgery , Aarhus University Hospital , Aarhus , Denmark.|b Deparment of Clinical Medicine , Aarhus University Hospital , Aarhus , Denmark.
Johan
J
Heiberg
a Deparment of Cardiothoracic & Vascular Surgery , Aarhus University Hospital , Aarhus , Denmark.|b Deparment of Clinical Medicine , Aarhus University Hospital , Aarhus , Denmark.
Kaj-Erik
KE
Klaaborg
a Deparment of Cardiothoracic & Vascular Surgery , Aarhus University Hospital , Aarhus , Denmark.|b Deparment of Clinical Medicine , Aarhus University Hospital , Aarhus , Denmark.
Vibeke E
VE
Hjortdal
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 / Q000601:surgery*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D003718:Denmark; D004452:Echocardiography; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
Aortic valve stenosis; TAVI; health-related quality-of-life; treatment outcome; valve replacement