Quality of life in patients with transcatheter aortic valve implantation: an analysis from the INTERVENT project

Abstract

BackgroundTranscatheter aortic valve implantation (TAVI) is a standard treatment for patients with aortic valve stenosis due to its very low mortality and complication rates. However, survival and physical integrity are not the only important factors. Quality of life (QoL) improvement is a crucial part in the evaluation of therapy success.MethodsPatients with TAVI were questioned about their QoL before, one month and one year after the intervention as part of the INTERVENT registry trial at Mainz University Medical Center. Three different questionnaires were included in the data collection (Katz ADL, EQ-5D-5l, PHQ-D).ResultsWe included 285 TAVI patients in the analysis (mean age 79.8 years, 59.4% male, mean EuroSCORE II 3.8%). 30-day mortality was 3.6%, complications of any kind occurred in 18.9% of the patients. Main finding was a significant increase in the general state of health measured on the visual analog scale by an average of 4.53 (± 23.58) points (BL to 1-month follow-up, p = 0.009) and by 5.19 (± 23.64) points (BL to 12-month follow-up, p = 0.016). There was also an improvement of depression symptoms, which was reflected in a decrease in the total value of the PHQ-D by 1.67 (± 4.75) points (BL to 12-month follow-up, p = 0.001). The evaluation of the EQ-5D-5l showed a significant improvement in mobility after one month (M = −0.41 (± 1.31), p < 0.001. Regarding the independence of the patients, no significant difference could be found. Apart from that, patients with risk factors, comorbidities or complications also benefited from the intervention despite their poor starting position.ConclusionWe could show an early benefit of QoL in TAVI patients with significant improvement in the subjective state of health and a decrease in symptoms of depression. These findings were consistent over 1 year of follow up.

Prevalence and predictive value of fluid overload in patients with severe symptomatic aortic valve stenosis

“…However, patients that are suitable for TAVI are mostly elderly and have a wide variety of comorbidities, with shorter life expectancy. This makes that their motive for valve replacement might be driven by symptom improvement, mental state and thus quality of life 12,13 . Future research on TAVI outcomes and risk prediction should therefore focus more on symptom improvement.…”

“…This makes that their motive for valve replacement might be driven by symptom improvement, mental state and thus quality of life. 12,13 Future research on TAVI outcomes and risk prediction should therefore focus more on symptom improvement. A combined prediction tool, for both symptomatic improvement and hard endpoints like mortality can be used in the clinical setting and help in expectation management and aid clinical decision making.…”