The impact of surgical aortic valve replacement on quality of life-a multicenter study

J Thorac Cardiovasc Surg. 2021 Apr;161(4):1204-1210.e7. doi: 10.1016/j.jtcvs.2019.09.184. Epub 2019 Oct 31.

Abstract

Objectives: To explore the effect of surgical aortic valve replacement on quality of life and the variance with age, particularly in patients at risk of deterioration.

Methods: In an observational, multicenter, cohort study of routinely collected health data, patients undergoing and electively operated between January 2011 and January 2015 with pre- and postoperative quality of life data were included. Patients were classified into 3 age groups: <65, 65-79, and ≥80 years. Quality of life was measured at baseline and at 1-year follow-up using the Short-Form Health Survey-12 or SF-36. We defined a >5-point difference as a minimal clinically important difference. Multivariable linear regression analysis, with adjustment for confounders, was used to evaluate the association between age and quality of life.

Results: In 899 patients, mean physical health increased from 55 to 66 and mental health from 60 to 66. A minimal clinically important decreased physical health was observed in 12% of patients aged <65 years, 16% of patients aged 65-79 years, and 22% of patients aged ≥80 years (P = .023). A decreased mental health was observed in 15% of patients aged <65 years, 22% of patients aged 65-79 years, and 24% aged ≥80 years (P = .030). Older age and a greater physical and mental score at baseline were associated with a decreased physical and mental quality of life (P < .001).

Conclusions: Patients surviving surgical aortic valve replacement on average improve in physical and mental quality of life; nonetheless, with increasing age patients are at higher risk of experiencing a deterioration.

Keywords: patient-reported outcomes; quality of life; surgical aortic valve replacement.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Valve / surgery*
  • Aortic Valve Disease* / epidemiology
  • Aortic Valve Disease* / mortality
  • Aortic Valve Disease* / psychology
  • Aortic Valve Disease* / surgery
  • Elective Surgical Procedures / mortality
  • Elective Surgical Procedures / psychology
  • Elective Surgical Procedures / statistics & numerical data
  • Female
  • Heart Valve Prosthesis Implantation* / mortality
  • Heart Valve Prosthesis Implantation* / psychology
  • Heart Valve Prosthesis Implantation* / statistics & numerical data
  • Humans
  • Male
  • Mental Health
  • Middle Aged
  • Patient Reported Outcome Measures
  • Quality of Life*