title: Twelve-month quality of life improvement and all-cause mortality in elderly patients undergoing transcatheter aortic valve replacement.
abstract: OBJECTIVE
  Restoration of quality of life (QoL) and improvement of clinical outcomes is crucial in elderly patients undergoing transcatheter aortic valve implantation (TAVI). We sought to evaluate changes in QoL and all-cause mortality 12 months after TAVI.
  
  
  METHODS
  A total of 101 patients who underwent TAVI were included. Patients were followed for 12 months. QoL was assessed at baseline and at 1, 6 and 12 months after TAVI using EQ-5D-3L with a visual analog scale (VAS).
  
  
  RESULTS
  Patients who reported some problems with mobility at baseline showed better mobility after 12 months (p = 0.001). On the other hand, those who reported issues with self-care, usual activity or pain did not show significant improvement (p = 0.41; p = 0.12; p = 0.27, respectively). Patients reporting anxiety at baseline improved 12 months later (p = 0.003). VAS score showed an incremental increase during follow-up (p&lt;0.001). Transfemoral access was associated with higher VAS score values after 1 month (median (IQR): 65.0 (50.0-75.0) vs. 54.0 (50.0-60.0); p = 0.019) but not after 12 months (70.0 (62.5-80.0) vs. 67.5 (55.0-70.0); p = 0.07) as compared to non-transfemoral access. In multivariable regression analysis, only age and the presence of coronary chronic total occlusion were independently associated with VAS score at 12 months. In-hospital, 1-, 6- and 12-month mortality rates were 6.9%, 10.9%, 15.8 and 17.8%, respectively.
  
  
  CONCLUSIONS
  TAVI provides improved QoL with relatively good clinical outcomes. However, not all components of QoL may be improved. Patients treated with transfemoral access might have better QoL than those who had non-transfemoral access, especially early after TAVI.
authors.affiliation: Institute of Cardiology, Krakow - Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Kleczyński
authors.affiliation: Institute of Cardiology, Krakow - Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Bagieński
authors.affiliation: Institute of Cardiology, Krakow - Poland.
authors.forename: Artur
authors.initials: A
authors.lastname: Dziewierz
authors.affiliation: Institute of Cardiology, Krakow - Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Rzeszutko
authors.affiliation: Institute of Cardiology, Krakow - Poland.
authors.forename: Danuta
authors.initials: D
authors.lastname: Sorysz
authors.affiliation: Institute of Cardiology, Krakow - Poland.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Trębacz
authors.affiliation: Institute of Cardiology, Krakow - Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Sobczyński
authors.affiliation: Institute of Cardiology, Krakow - Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Tomala
authors.affiliation: Institute of Cardiology, Krakow - Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Stąpór
authors.affiliation: Institute of Cardiology, Krakow - Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Dudek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D065467:Transcatheter Aortic Valve Replacement / Q000401:mortality* / Q000523:psychology; D016896:Treatment Outcome