Expectation and Quality of Life after Aortic Valve Replacement over 85 Years of Age Match those of the Contemporary General Population

Salsano, Antonio; Regesta, Tommaso; Viganò, G.; Rapetto, Filippo; Boeddu, S.; Sportelli, Elena; Pansini, Stefano; Risso, P.; Passerone, Giancarlo; Santini, Francesco

doi:10.5301/ijao.5000473

Cited by 7 publications

(3 citation statements)

References 34 publications

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“…On the other hand, there is data available that isolated AVR in patients aged ≥85 years can be performed with acceptable risk. The survivors improve in NYHA class and, when compared to age- and gender-matched individuals, show a similar life expectancy and a QoL that is no lower (21).…”

Section: Discussionmentioning

confidence: 99%

Twelve-Month Quality of Life Improvement and All-Cause Mortality in Elderly Patients Undergoing Transcatheter Aortic Valve Replacement

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Twelve-Month Quality of Life Improvement and All-Cause Mortality in Elderly Patients Undergoing Transcatheter Aortic Valve Replacement

et al. 2016

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“…Twenty-two studies [ 5 , 7 , 9 , 11 , 13 , 17 – 21 , 27 , 29 , 34 , 38 , 39 , 41 , 45 , 50 – 53 ] reported long-term survival comparison between the two surgical interventions with a mean follow-up ranging from 2.1 years [ 27 ] to 9.5 years [ 45 ]. The weighted mean follow-up was 3.2 years.…”

Section: Resultsmentioning

confidence: 99%

The early and long-term outcomes of coronary artery bypass grafting added to aortic valve replacement compared to isolated aortic valve replacement in elderly patients: a systematic review and meta-analysis

et al. 2022

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In aged population, the early and long-term outcomes of coronary revascularization (CABG) added to surgical aortic valve replacement (SAVR) compared to isolated SAVR (i-SAVR) are conflicting. To address this limitation, a meta-analysis comparing the early and late outcomes of SAVR plus CABG with i-SAVR was performed. Electronic databases from January 2000 to November 2021 were screened. Studies reporting early-term and long-term comparison between the two treatments in patients over 75 years were analyzed. The primary endpoints were in-hospital/30-day mortality and overall long-term survival. The pooled odd ratio (OR) and hazard ratio (HR) with 95% confidence interval (CI) were calculated for in-early outcome and long-term survival, respectively. Random-effect model was used in all analyses. Forty-four retrospective observational studies reporting on 74,560 patients (i-SAVR = 36,062; SAVR + CABG = 38,498) were included for comparison. The pooled analysis revealed that i-SAVR was significantly associated with lower rate of early mortality compared to SAVR plus CABG (OR = 0.70, 95% CI 0.66–0.75; p < 0.0001) and with lower incidence of postoperative acute renal failure (OR = 0.65; 95% CI 0.50–0.91; p = 0.02), need for dialysis (OR = 0.65; 95% CI 0.50–0.86; p = 0.002) and prolonged mechanical ventilation (OR = 0.57; 95% CI 0.42–0.77; p < 0.0001). Twenty-two studies reported data of long-term follow-up. No differences were reported between the two groups in long-term survival (HR = 0.95; 95% CI 0.87–1.03; p = 0.23). CABG added to SAVR is associated with worse early outcomes in terms of early mortality, postoperative acute renal failure, and prolonged mechanical ventilation. Long-term survival was comparable between the two treatments.

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“…Data obtained in our study demonstrated a similar rate of problems with usual activities in the male group in comparison to the female group at 12-month follow-up, with no difference in QoL improvement after TAVI. This may suggest an equal response to TAVI in regard to symptoms and everyday activities in men and women [ 29 , 30 ]. Frailty assessment has also been shown as an important factor of overall health status, which is combined with morbidity and mortality in various clinical settings [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Sex-related differences in clinical outcomes and quality of life after transcatheter aortic valve implantation for severe aortic stenosis

Bagieński¹,

Tokarek²,

Wiktorowicz³

et al. 2017

pwki

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IntroductionThere are inconsistent data on the sex-related differences in clinical outcomes and quality of life (QoL) after transcatheter aortic valve implantation (TAVI).AimWe sought to investigate sex-related differences in procedural, clinical and QoL outcomes of TAVI.Material and methodsA total of 101 consecutive patients undergoing TAVI were enrolled. Patients were stratified by gender. Baseline characteristics, procedural and long-term clinical outcomes as well as frailty and QoL indices (EQ-5D-3L questionnaire) were compared between women and men.ResultsWomen represented 60.4% of the study population. Periprocedural risk measured with the Logistic EuroSCORE and STS scale was similar for women and men. There were no differences in 30-day or 12-month all-cause mortality between groups (women vs. men: 9.8% vs. 12.5%; age-adjusted odds ratio (OR) (95% CI): 1.38 (0.39–4.94); 13.1% vs. 25.0%; age-adjusted OR (95% CI): 2.51 (0.87–7.25)). Men were at higher risk of new onset atrial fibrillation at follow-up (1.6% vs. 17.5%; age-adjusted OR (95% CI): 14.61 (1.68–127.37)). In multivariable Cox regression analysis, a history of stroke/transient ischemic attack (TIA) (hazard ratio (HR)) (95% CI): 3.93 (1.39–11.07) and blood transfusion (HR (95% CI): 2.84 (1.06–7.63)) were identified as independent factors affecting 12-month mortality. No differences in QoL parameters were noted.ConclusionsThe TAVI can be considered as an effective and safe treatment in high-risk patients with severe aortic stenosis, regardless of gender.

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Expectation and Quality of Life after Aortic Valve Replacement over 85 Years of Age Match those of the Contemporary General Population

Abstract: Isolated AVR in patients aged ≥85 years can be performed with acceptable risk. Survivors improve in NYHA class and, when compared to age- and gender-matched individuals, show a similar life expectancy and a no lower QoL.

Cited by 7 publications

References 34 publications

Twelve-Month Quality of Life Improvement and All-Cause Mortality in Elderly Patients Undergoing Transcatheter Aortic Valve Replacement

Twelve-Month Quality of Life Improvement and All-Cause Mortality in Elderly Patients Undergoing Transcatheter Aortic Valve Replacement

The early and long-term outcomes of coronary artery bypass grafting added to aortic valve replacement compared to isolated aortic valve replacement in elderly patients: a systematic review and meta-analysis

Sex-related differences in clinical outcomes and quality of life after transcatheter aortic valve implantation for severe aortic stenosis

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