Surgical aortic valve replacement in elderly patients: effects on physical performance, cognitive function and health-related quality of life

• Published in: Aging clinical and experimental research Vol. 34; no. 3; pp. 643 - 652
• Main Authors: De Rui, Marina, Tarzia, Vincenzo, Mazzochin, Mattia, Bertocco, Anna, Ceolin, Chiara, Trevisan, Caterina, Tessari, Chiara, Cavalli, Chiara, Piperata, Antonio, Coin, Alessandra, Gerosa, Gino, Sergi, Giuseppe
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-03-2022; Springer Nature B.V
• Subjects: Activities of daily living; Aged; Aged, 80 and over; Aging; Aortic stenosis; Aortic Valve - surgery; Aortic Valve Stenosis - surgery; Cognition; Cognitive ability; Frailty; General anesthesia; Geriatrics; Geriatrics/Gerontology; Heart surgery; Heart Valve Prosthesis Implantation - adverse effects; Heart Valve Prosthesis Implantation - methods; Humans; Medical prognosis; Medicine; Medicine & Public Health; Morbidity; Mortality; Nutritional status; Older people; Original; Original Article; Patient satisfaction; Physical Functional Performance; Prospective Studies; Quality of Life; Risk Factors; Thoracic surgery; Transcatheter Aortic Valve Replacement; Treatment Outcome; Mood; Short physical performance battery; Older adults; Aortic valve stenosis; Nutritional status; Quality of life
• ISSN: 1720-8319; 1594-0667; 1720-8319
• DOI: 10.1007/s40520-021-01969-x

Background
Surgical aortic valve replacement (SAVR) is still the gold standard for treating aortic valve stenosis (AVS). Its effectiveness has been extensively examined in terms of perioperative mortality, but its impact on overall health has received much less attention.
Aims
To assess the physical performance, cognitive status, and health-related quality of life of elderly patients undergoing SAVR, in the short, medium and long term.
Methods
This single-center prospective study enrolled patients aged > 70 years who underwent isolated SAVR for severe AVS. Data were collected on each participant’s clinical status, physical performance, cognitive status, mood, and health-related quality of life. This multidimensional geriatric assessment was performed before surgery (T0), and again at 45 days (T1), 3 months (T2), 6 months (T3), and 12 months (T4) post-surgery. Baseline (T0) and follow-up (T2-T4) data were compared separately for patients grouped by gender using paired t-tests.
Results
Data from a total of 35 patients were analyzed. Compared with the baseline (T0), nutritional status worsened at T1, then gradually improved through to T4. Physical performance, mood, and health-related quality of life improved significantly after surgery. Cognitive function showed no change through to T3, but then deteriorated at T4.
Conclusions
Our results show that SAVR in patients over 70 years of age has a positive impact on nutrition, mood, and health-related quality of life. Cognitive function was not negatively affected in the short and medium term, although it deteriorated in the long term. SAVR also had a positive impact on the physical performance of our sample.