Quality of life improvement at midterm follow-up after transcatheter aortic valve implantation

Abstract

BackgroundTranscatheter aortic valve implantation (TAVI) techniques have been presenting good procedural success and favorable clinical outcomes. However, optimal management of aortic valve disease in elderly patients depends on quality of life (QoL) improvement. In this study we aimed to evaluate changes in QoL in patients referred for TAVI. Methods and resultsProspective analysis of 74 consecutive patients (34 male), aged 81.6±8years with symptomatic severe aortic valve stenosis (AS) ineligible for conventional aortic valve replacement, referred to TAVI in one tertiary center. For the assessment of QoL, the Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used before the procedure and at 6.5months. The mortality was 9.5% at 30days and 20.2% at 6.5months follow-up. Fifty three (71.6%) patients completed MLHFQ at baseline and at follow-up. All patients showed good hemodynamic results and no signs of prosthesis dysfunction were observed on transthoracic echocardiography. The New York Heart Association (NYHA) class (2.9±0.4 to 1.4±0.7; p<0.001), and the MLHFQ scores [overall (37.0±14.7 vs. 14.4±10.1; p<0.001), physical dimension (23.2±9.5 vs. 8.6±5.9; p<0.001) and emotional dimension (5.4±4.2 vs. 2.6±3.0; p<0.001)] were significantly improved 6.5months after TAVI. Patients with peripheral vascular disease (PVD) had an inferior improvement in QoL caused by a lower enhancement in physical dimension MLHFQ score (mean difference: −17.0±10.2 vs. −10.1±11.5; p=0.036). ConclusionTAVI significantly improves symptoms and QoL in patients with severe AS and high surgical risk. Patients with PVD might be expected to have a less impressive improvement in QoL after TAVI.