Quality of life after aortic valve repair is similar to Ross patients and superior to mechanical valve replacement: a cross-sectional study

Abstract

BackgroundIn patients after aortic valve surgery, the quality of life is hypothesized to be influenced by the type of the valve procedure. A cross-sectional study on the postoperative quality of life was carried out in patients after aortic valve-sparing surgery (with regards to the age of the patient), Ross procedure and mechanical aortic valve replacement.MethodsQuality of life was studied in 139 patients after aortic valve surgery divided into four study groups (Y – aortic valve-sparing procedure at the age below 50 years, mean age 36.2 years; O – aortic valve-sparing procedure at the age 50 years and over, mean age 59.2 years; R – Ross procedure, mean age 37.8 years and M – mechanical aortic valve replacement at the age below 50 years, mean age 39.2 years). SF-36 Short Form and valve-specific questionnaires were mailed to the patients after 6 months or later following surgery (median 26.9 months).ResultsIn SF-36, the younger aortic valve repair patients and the Ross patients scored significantly better in 4 of 4 physical subscales and in 2 of 4 mental subscales than the older aortic valve repair and mechanical valve replacement patients. In the valve-specific questionnaire; however, all 3 groups free of anticoagulation (Y, O, and R) displayed greater freedom from negative valve-related concerns.ConclusionsPostoperative quality of life is influenced by the type of aortic valve procedure and is negatively linked with mechanical prosthesis implantation and long-term anticoagulation. Aortic valve-sparing strategy should be considered in cases with suitable valve morphology due to favorable clinical results and beneficial impact on the long-term quality of life.

Clinical and quality of life outcomes after aortic valve replacement and aortic root surgery in adult patients <65 years old

“…Patients who received mechanical prostheses had worse general health, physical functioning and mental health and more cardiac-related anxiety (18). These observations have been confirmed by several other studies, that all point into the direction of a better QoL with a biological solution (19,20).…”

Current and Future Aspects of Multimodal Imaging, Diagnostic, and Treatment Strategies in Bicuspid Aortic Valve and Associated Aortopathies

“…While most of the patients treated by the ROSS-procedure are younger [43], post-operative aortic root expansion can be prevented through stabilization with a prosthetic Dacron graft [44]. Recently published long-term results are encouraging, showing favorable hemodynamics, quality of life, and freedom of re-surgery after nine years of follow-up [45,46].…”

Current status of the Ross procedure in aortic valve surgery

“…Tyto výsledky byly reprodukovány několika současnými studiemi u mladých nemocných po náhradě aortální chlopně, s desetiletým přežíváním v rozmezí 75-85 %, tedy podstatně nižším než u populace odpovídající věkem a pohlavím [15,16]. Navíc kvalita života u nemocných po náhradě aortální chlopně byla nižší v porovnání s operacemi bez chlopenní protézy, jako jsou záchovné aortální výkony nebo Rossova operace [17][18][19].…”