Abstract

Objective:Transcatheter aortic valve implantation has recently been used in the treatment of severe aortic valve stenosis, particularly in patients with high mortality and morbidity rates for open surgery. The purpose of this study was to compare quality of life in patients over 70 years of age undergoing surgical or transcatheter aortic valve implantation, before the procedure and in the early post-procedural period.Methods:Seventy-nine patients were included in the study, 38 (48.1%) male and 41 (51.9%) female. Mean age of patients was 74.3±5.2 (70-91) years. The surgical aortic valve replacement group consisted of 51 (64.6%) patients and the transcatheter aortic valve replacement group of 28 (35.4%). Quality of life data before the procedure and at the 3rd month postoperatively in patients aged 70 years and older undergoing surgical or transcatheter aortic valve implantation were assessed using the 36-item Short Form Health Survey form.Results:Positive increases in physical task difficulty (13.2±9.8 vs. 5.1±7.3) (P=0.001), emotional task difficulty (14.4±11.9 vs. 8.5±6.4) (P=0.035), and mental health (0.4±10.4 vs. 9.6±15.1) (P=0.001; P<0.01) scores in patients undergoing transcatheter aortic valve replacement were significantly higher compared to the surgical aortic valve replacement group. No statistically significant difference was determined between the groups in terms of pain, vitality, social function, physical function or general health scores in the preoperative and postoperative periods.Conclusion:The positive increase in quality of life parameters in the transcatheter aortic valve implantation group at the 3rd month postoperatively was significantly higher compared to the surgical aortic valve replacement group.

Highlights

  • Aortic stenosis (AS) is a common valve disease and if left untreated, the prognosis of severe AS is poor

  • Positive increases in physical task difficulty (13.2±9.8 vs. 5.1±7.3) (P=0.001), emotional task difficulty (14.4±11.9 vs. 8.5±6.4) (P=0.035), and mental health (0.4±10.4 vs. 9.6±15.1) (P=0.001; P

  • The positive increase in quality of life parameters in the transcatheter aortic valve implantation group at the 3rd month postoperatively was significantly higher compared to the surgical aortic valve replacement group

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Summary

Introduction

Aortic stenosis (AS) is a common valve disease and if left untreated, the prognosis of severe AS is poor. A surgical approach involving open heart surgery with low levels of mortality and acceptable long-term morbidity levels has been successfully applied in severe AS. The risk of perioperative morbidity and mortality increases in elderly patients or those with accompanying diseases and they may be regarded as inoperable. Transcatheter aortic valve implantation (TAVI) was initially introduced by Cribier and colleagues and, currently, TAVI represents a valid therapeutic option for patients with severe aortic stenosis who are inoperable or are at very high risk for conventional surgery[1,2]. TAVI is performed using one of two. Our research was carried out at Dr.Siyami Ersek Cardiovascular and Thoracic Surgery Hospital, Department of Cardiovascular Surgery, İstanbul, Turkey.

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