Quality of life after aortic valve surgery: Replacement versus reconstruction

Abstract

Quality of life has been shown to be influenced by aortic valve replacement, particularly in younger patients. Aortic valve repair is a recent alternative to replacement. We investigated quality of life and anxiety and depression after aortic valve repair and compared with 2 established replacement alternatives, mechanical valve and pulmonary autograft. In a cross-sectional study, 166 patients (age, 18-45 years) were studied after isolated elective aortic valve surgery. They had undergone aortic valve repair (group I, n=86), replacement with mechanical prosthesis (group II, n=41), or pulmonary autograft (group III, n=39). Assessment was performed by Short Form Health Survey, Hospital Anxiety and Depression Scale, Cardiac Anxiety Questionnaire, and valve-specific questions. In Short Form Health Survey, groups I and III revealed similar or identical scores better than group II in physical functioning (P=.02), general health (P=.03), and mental health (P=.05). No differences were found in Hospital Anxiety and Depression Scale score. In cardiac anxiety, there was less heart-focused attention in groups I and III than in group II (P=.043, P=.053). In response to valve-specific questions, there were no differences between groups I and III. Interestingly, fear of reoperation was identical in all 3 groups. In young patients after aortic valve surgery quality of life is influenced by type of operation. Although differences are limited, aortic valve reconstruction and pulmonary autograft replacement lead to less long-term alteration from normal values.