Comparison of Health Related Quality of Life in Transcatheter Versus Surgical Aortic Valve Replacement: A Meta-Analysis

Abstract

Data on the effects of transcatheter aortic valve replacement (TAVR) compared to surgical aortic valve replacement (SAVR) on health-related quality of life (HRQOL) outcomes are limited. To assess the comparative HRQOL outcomes between TAVR and SAVR, we performed a systematic review and meta-analysis. PubMed and EMBASE databases were searched for articles that compared the HRQOL scores, Kansas City Cardiomyopathy Questionnaire (KCCQ), Medical Outcomes Study Short-Form Health Survey 12 or 36 (SF-12/36), or the EuroQoL 5 Dimension score (EQ-5D) at 30days and 1year between TAVR and SAVR. Mean difference (MD) and 95% confidence interval (CI) was calculated with inverse variance statistical method and random-effects model. A total of four studies with 4,125 patients (1268 transfemoral [TF]-TAVR, 1261 Non-TF TAVR [transsubclavian, transapical or transaortic], and 1,596 SAVR) were included in the studies. KCCQ overall summary scores and its subscales, SF-12/36, and EQ-5D were significantly higher in TF-TAVR compared to SAVR but were similar in non-TF TAVR vs. SAVR at 30 days. At 1-year follow-up, TF-TAVR and non-TF TAVR conferred similar HRQOL scores in KCCQ overall summary and subscales scores, SF-12/36, and EQ-5D compared to SAVR. Transfermoral-TAVR achieved better HRQOL at 30days but similar HRQOL at 1year compared to SAVR. Non-TF TAVR resulted in similar improvements in HRQOL at both 30days and 1year compared with SAVR.