Health-related quality-of-life after transapical transcatheter aortic valve implantation. (1st November 2016)

• Record Type: Journal Article
• Authors: Rex, Christian E.; Heiberg, Johan; Klaaborg, Kaj-Erik; Hjortdal, Vibeke E.
• Is Part Of: Scandinavian cardiovascular journal. Volume 50:Number 5/6(2016:Oct.)
• Page Start: 377
• Page End: 382
• Publication Date: 2016-11-01
• Subjects: Aortic valve stenosis -- TAVI -- valve replacement -- treatment outcome -- health-related quality-of-life; Cardiovascular system -- Diseases -- Periodicals; 617.41
• DOI: 10.1080/14017431.2016.1235725
• Languages: English
• ISSNs: 1401-7431

Abstract

Abstract: Purpose. Transcatheter aortic valve implantation (TA-TAVI) is a well-established treatment for aortic valve stenosis in high-risk patients and indications have been continuously expanding to also include intermediate-risk patients. However, in low-risk patients, experiences are still sparse and although clinical outcomes have been shown favorable results, HRQoL has remained unexplored. The aim of this report was to describe the long-term health-related quality-of-life (HRQoL) in low-risk patients randomized to TA-TAVI or surgical aortic valve replacement (SAVR). Methods. In a prospective, randomized trial, patients with aortic valve stenosis were randomized to either TA-TAVI or SAVR. TA-TAVI was performed through a mini thoracotomy with the introduction of prosthesis via the apex of the heart and antegradely advancement over the pre-dilated native valve. SAVR was performed during cardiopulmonary bypass with resection of the native valve and replacement with a prosthesis valve through a median sternotomy. Afterwards, patients were followed yearly with echocardiography and HRQoL assessment. Results. A total of 58 patients were included; 29 patients for TA-TAVI and 29 patients for SAVR. The only difference in HRQoL was found in the physical component summary after 1 year; 44 ± 9 in the TA-TAVI group compared with 36 ± 9 in the SAVR group, p = .03. There were no differences in any of the remaining timepoints in neither physical nor mental component summary, p = .19 and p = .98, respectively, and there were no differences in survival during the 5 years. Conclusions. In low-risk patients with aortic valve stenosis undergoing TA-TAVI, no differences appeared in HRQoL compared with SAVR during a 5-year follow-up period.