[Quality of life after transcatheter aortic valve implantation: a Comprehensive literature review and critical appraisal].
Transcatheter aortic valve implantation (TAVI) is a very effective treatment option for patients with severe aortic stenosis who are either not suitable candidates or at high risk for surgical aortic valve replacement (AVR). Patients undergoing TAVI are often very elderly and their clinical status is burdened with multiple comorbidities, therefore evaluation of quality of life (QoL) might be challenging. We sought to provide an overview of available data on QoL changes after TAVI and critical insights on the instruments used to detect these changes.



This analysis focuses on studies that evaluated QoL after TAVI with standardized questionnaires. Out of 706 items identified through literature search, 23 studies were included in the final review: 2 randomized controlled trials (one comparing QoL pre- vs post-TAVI, one TAVI vs AVR vs medical therapy) and 21 observational studies (19 studies comparing QoL pre- and post-TAVI and 2 studies TAVI vs AVR). The instruments used in all studies were not specific for TAVI patients.



Most studies reported a significant improvement in QoL after TAVI, greater for physical aspects compared with psychological components, which persisted at mid and long-term follow-up. A short-term benefit was found for transfemoral TAVI patients as compared with transapical TAVI and AVR; however, these differences tended to disappear over time.



The study highlights an improvement in QoL after TAVI that persists over time. As different instruments resulted to be more sensitive to detect different aspects, multidimensional assessments - capable of combining disease-specific and disease-non-specific measures - should foster clinical research in order to have a more complete picture of QoL of TAVI patients.
Dipartimento di Psicologia, Università degli Studi, Bologna.
Susy
S
Ferrari
U.O. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna.
Cristina
C
Ciuca
SCDU Geriatria e Malattie Metaboliche dell'Osso, Città della Salute e della Scienza-Molinette, Torino.
Enrica
E
Grisoglio
U.O. Cardiologia, Ospedale Mauriziano Umberto I, Torino.
Tiziana Claudia
TC
Aranzulla
U.O. Cardiochirurgia, Hesperia Hospital, Modena.
Davide
D
Gabbieri
U.O. Cardiologia, ARNAS Ospedale Civico Di Cristina Benfratelli, Palermo.
Lavinia
L
Vecchio Verderame
U.O. Cardiologia, ARNAS Ospedale Civico Di Cristina Benfratelli, Palermo.
Flavia
F
Dispensa
U.O. Cardiologia, Azienda Ospedaliero-Universitaria Policlinico Vittorio Emanuele, Ospedale Ferrarotto, Catania.
Cinzia
C
Caruso
U.O. Cardiologia, Azienda Ospedaliero-Universitaria Policlinico Vittorio Emanuele, Ospedale Ferrarotto, Catania.
Alda Carmela
AC
Di Mauro
U.O. Cardiochirurgia, Azienda Sanitaria Ospedaliera S. Croce e Carle, Cuneo.
Omar
O
Di Gregorio
U.O. Cardiologia, A.O. San Camillo-Forlanini, Roma.
Claudia
C
Pandolfi
U.O. Cardiologia, A.O. San Camillo-Forlanini, Roma.
Silvia
S
Rongoni
Dipartimento di Psicologia, Università degli Studi, Bologna.
Giovanni
G
Ottoboni
U.O. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna.
Carolina
C
Moretti
Agenzia Sociale e Sanitaria Regionale, Regione Emilia-Romagna, Bologna.
Rossana
R
De Palma
U.O. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna.
Antonio
A
Marzocchi
Dipartimento di Psicologia, Università degli Studi, Bologna.
Rabih
R
Chattat
U.O. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna.
Francesco
F
Saia
D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D006306:Health Surveys; D006801:Humans; D011788:Quality of Life; D065467:Transcatheter Aortic Valve Replacement