Quality of life after aortic valve replacement

Abstract

Understanding the quality of life after aortic valve replacement has become increasingly important. As aortic valve replacement numbers increase, more patients, physicians and families are affected by the subsequent quality of life. Quality of life information can inform the decision to perform aortic valve replacement and the selection of replacement valve. When reviewing quality of life results, it is important to realize that the findings are affected by the selection and quality of instruments, as many studies have not used valid or reliable instruments. Studies have shown that aortic valve replacement appears to significantly improve the quality of life of survivors, including those older than 70 years of age and even decades after the procedure, quality of life remains high. Studies have suggested that the elderly may gain as much quality of life benefit as younger patients. No consistent differences in resulting total quality of life have been observed between mechanical and bioprosthetic valves. Only one study showed some quality of life benefits of pulmonary autograft over mechanical valves. It is unclear whether minimally invasive aortic valve replacements confer better quality of life than standard aortic valve replacements. While existing quality of life studies have provided important information, more studies are needed especially as valve technology and operative techniques continue to improve. Future studies should endeavor to use validated general and disease-specific instruments and quantify the effects of demographics, preoperative clinical conditions and intraoperative variables on quality of life outcomes.

The Quality of Life in Patients With Valve Prosthesis After Undergoing Surgery for Valvular Heart Diseases

“…Moreover, administrative and financial burdens might persist even beyond the hospital stay. Patients’ perceptions of their QoL following valve replacement surgery may be influenced by physical restrictions, discomfort, and the presence of scars [ 11 ]. An increasing number of older patients are undergoing open heart surgery.…”

Minimal Access Aortic Valve Surgery

“…In particular, the relative technical challenges of performing surgery through reduced access incisions can increase cardiopulmonary bypass and ischaemic surgical time, paradoxically increasing the invasiveness of the procedure. The invasiveness of cardiac surgery, some have posited, is as much contributed to by the deleterious effects of cardiopulmonary bypass as it is by the trauma of sternotomy, which is generally well tolerated [15,16]. Efforts to mitigate for both to make incremental gains have included a plethora of techniques and approaches, each with various advantages, disadvantages, and prerequisites.…”

Effect of minimally invasive versus conventional aortic root replacement on transfusion and postoperative wound complications in patients: A meta‐analysis

“…While there is a wide range of published literature about the application of minimally invasive procedures to treat aortic root disease, there is little or no conclusive evidence to support this approach 21,22 . While the medial sternotomy is generally acceptable because the breastbone is fixed at the time of closure, it is still painful and affects breathing 23,24 . By preserving the integrity of the chest, minimally invasive surgical procedures are designed to reduce pain, movement and recovery from the hospital 25 .…”

“… 21 , 22 While the medial sternotomy is generally acceptable because the breastbone is fixed at the time of closure, it is still painful and affects breathing. 23 , 24 By preserving the integrity of the chest, minimally invasive surgical procedures are designed to reduce pain, movement and recovery from the hospital. 25 It is believed that these advantages will compensate for the additional time needed for surgery.…”