Quality of life and frailty outcomes following surgical and transcatheter aortic valve replacement

Abstract

Background Our objective was to report on the prospective outcomes in the areas of depression, quality of life, angina, and frailty in SAVR and TAVR patients with aortic stenosis undergoing aortic valve intervention. Methods We recruited 300 patients across 3 groups (TAVR, SAVR, and CABG) over 12 months. Depression, quality of life, frailty, and angina were assessed followed by propensity score matching. Results Using logistical regression when all patient factors considered for all patients who had SAVR and TAVR, the only preoperative factors that impacted on 1 year mortality was hypertension and STS score. Quality of life improvements within each group over 12 months was significant (p value = 0.0001). Depression at 12 months between groups (p value = 0.0395) and within each group was significant (p value = 0.0073 for SAVR and 0.0001 for TAVR). Angina was most frequent in TAVR at 12 months in the QL (p = 0.0001), PL (p = 0.0007), and improvement was significant in the QL (SAVR p = 0.0010, TAVR p = 0.0001) and PL (SAVR p = 0.0002), TAVR p = 0.0007) domains in both groups. Frailty at 12 months improved in both groups, but was greatest in TAVR (p value = 0.00126). Conclusions This 12 months follow up of cardiac surgical patients has revealed significant improvement in PROMs and frailty in all groups by 3 months postoperative regardless of surgical or transcatheter approach. Outcome measures of quality of life and frailty could be utilized as a measure of outcome more regularly in patients undergoing aortic valve surgery regardless of approach.

Surgical vs. transcatheter arotic valve replacement in patients over 75 years with aortic stenosis: sociodemographic profile, clinical characteristics, quality of life and functionality

“…Our results are similar to those reported by other authors ( Adams, Popma & Reardon, 2014 ; Durko et al, 2018 ; Gavalaki et al, 2020 ; Lauck et al, 2020 ; Surman et al, 2022 ). Adams, Popma & Reardon (2014) ; evaluated quality of life with KCCQ, obtaining slightly higher scores in patients with TAVR.…”

Demystifying the Value of Minimal Clinically Important Difference in the Cardiothoracic Surgery Context

“…The TAVR procedures represent another field of potential interest for MCID method implementation. In fact, there has been a strong focus and investigation on the impact of TAVR on QoL of patients [ 32 ]. The studies that assessed the effect of TAVR on QoL mainly used patient-reported outcome measures (PROMS) [ 33 ].…”

Long-Term Outcomes of Mechanical Versus Bioprosthetic Aortic Valve Replacement: A Systematic Review and Meta-Analysis

“…Though no medical therapies exist to prevent disease progression, aortic valve replacement (AVR) serves as the definitive management for symptomatic and severe AS [2][3][4]. Clinical evidence has demonstrated improved symptomatic management, quality of life, and promising outcomes for long-term mortality [5][6][7]. As surgical AVR continues to serve as the gold standard treatment for patients with severe AS, the choice of a mechanical valve (MV) or bioprosthetic valve (BV) is subject to various factors such as age, indications for anticoagulation therapy, risks of valve re-intervention and patient values and preferences [4].…”