Quality-of-life in elderly patients one year after transcatheter aortic valve implantation for severe aortic stenosis

• Published in: EuroIntervention Vol. 7; no. 5; pp. 573 - 579
• Main Authors: USSIA, Gian Paolo, BARBANTI, Marco, GULINO, Simona, TAMBURINO, Corrado, CAMMALLERI, Valeria, SCARABELLI, Marilena, MULE, Massimiliano, ARUTA, Patrizia, PISTRITTO, Anna Maria, IMME, Sebastiano, CAPODANNO, Davide, SARKAR, Kunal
• Format: Journal Article
• Language: English
• Published: Toulouse Société Europa Edition 01-09-2011
• Subjects: Age Factors; Aged; Aged, 80 and over; Analysis of Variance; Aortic Valve Stenosis - diagnosis; Aortic Valve Stenosis - mortality; Aortic Valve Stenosis - physiopathology; Aortic Valve Stenosis - psychology; Aortic Valve Stenosis - therapy; Biological and medical sciences; Cardiac Catheterization - adverse effects; Cardiac Catheterization - instrumentation; Cardiac Catheterization - mortality; Cardiology. Vascular system; Chi-Square Distribution; Endocardial and cardiac valvular diseases; Female; Geriatric Assessment; Heart; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation - adverse effects; Heart Valve Prosthesis Implantation - instrumentation; Heart Valve Prosthesis Implantation - methods; Heart Valve Prosthesis Implantation - mortality; Humans; Italy; Male; Medical sciences; Prospective Studies; Prosthesis Design; Quality of Life; Recovery of Function; Risk Assessment; Risk Factors; Severity of Illness Index; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surveys and Questionnaires; Time Factors; Treatment Outcome; Italy; Human; Aortic stenosis; Health; TAVI; Cardiovascular disease; Implantation; Patient; Quality of life; Cardiac valvular disease; quality-of-life; Severe; Elderly; Aortic valve
• ISSN: 1774-024X; 1969-6213
• DOI: 10.4244/EIJV7I5A93

Transcatheter aortic valve implantation (TAVI) is an emerging alternative to medical therapy reserved to a limited population with severe aortic stenosis. Quality-of-life (QoL) is a critical measure of effectiveness of TAVI in this patient population. In this prospective study, we sought to assess one year changes in QoL in patients who underwent TAVI.
From June 2007 to July 2010, 149 consecutive patients underwent TAVI using the 18 Fr CoreValve (Medtronic Inc, Minneapolis, MN, USA) or the Edwards SAPIEN XT heart valve (Edwards Lifescience, Irvine, CA, USA) at our institution. Of these, 143 patients with successful prosthesis implantation comprised the study population. The SF-12v2 Health-Survey questionnaire provides scales for physical (physical component summary [PCS]) and mental (mental component summary [MCS]) health. Among patients included in the present analysis, device success was obtained in 138 patients (96.5%). Mean preprocedural SF-12v2 scores showed an important upgrading after TAVI: PCS improved from 28.3 to 44.0 at five months and 42.4 at 12 months (p<0.001). MCS increased from 38.0 to 47.3 at five months and 48.2 at 12 months (p<0.001). Both the physical and mental score summaries at follow-up of these post-TAVI patients were not significantly different from the anticipated thresholds of the general Italian population over the age of 75 years. NYHA functional class improvement was reported in all patients.
Our results showed a marked mid-term improvement in functional status and physical and mental health in patients who underwent TAVI.