Динамика качества жизни пациентов с аортальным стенозом после протезирования биологическим или механическим протезом

Abstract

To assess dynamics of the quality of life (QOL) in patients of the older age group of with initial aortic stenosis in 1, 3, and 5 years after replacement of the aortic valve (AV) with biological or mechanical prosthesis. QOL was assessed in 282 patients who underwent aortic valve replacement with a biological or mechanical prosthesis. Criterion for inclusion in this retrospective single-center study was primary and elective nature of the operation. Patients with repeated interventions (early postoperative resternotomy, reosteosynthesis, repeat aortic valve surgery) were not included. Using the method of Propensity Score Matching, we distributed 151 patients in whom the long-term results of AV replacement were analyzed according to age, gender, body mass index into groups of AV replacement with biological (group 1, n=74) and mechanical (group 2, n=77) prosthesis. In the early period after operation, there was no significant difference between groups in parameters of quality of life. During the observation period up to 3 years significant increases of parameters bodily pain (BP), vitality (VT), and mental health (MH) occurred in patients with biological prostheses, while physical functioning (PF) was higher in patients with mechanical prostheses. At follow-up to 5 years, indicators such as BP and role emotional functioning (RE) became higher in patients with mechanical prostheses. According to the conducted regression analysis the type of prosthesis affected the quality of life. 1) AV replacement with mechanical prostheses was associated with lowering of the physical component of health by 81.1%, and of the mental health component - by 56.6% per month; 2) significant difference in QOL between groups of patients with mechanical and biological prostheses could be detected only in 3 years after the operation: parameters BP, VT and MH were significantly higher in patients with biological prostheses, while PF was higher in patients with mechanical prostheses; 3) in the longer observation period (up to 5 years) parameters BP and RE became higher in patients with mechanical prostheses.