Quality of Life of Patients Treated for Abdominal Aortic Aneurysm: Open Surgery and Endoprosthesis

Abstract

Objectives: To determine the degree of long-term health-related quality of life (HRQoL) of patients undergoing surgery for abdominal aortic aneurysm (AAA) and to analyze the results according to the type of treatment, namely, open abdominal repair (OAR) or endoprosthesis (EVAR). Patients and Methods: This was a prospective cross-sectional observational study. Patients receiving intervention for AAA between January 2013 and December 2020 were included. The Spanish version of the SF-36 questionnaire was used. A single survey was performed on all patients, and the time elapsed since the intervention was recorded. Results: On all health scales and in the two groups of patients, the highest scores were recorded at six months postoperatively. At that time, the EVAR and OAR groups had similar values. Between 13 and 16 months postoperatively, EVAR patients presented a transient but significant decrease in their scores for physical function (p = 0.016), vitality (p = 0.035) and social function (p = 0.041). From that moment, there were progressive decreases in the scores of the two groups of patients on all the scales of the SF-36 questionnaire, although this trend was less pronounced in the OAR group. At 60 months after the intervention, the latter group showed significantly higher values than EVAR for physical function (p = 0.01), vitality (p = 0.032) and mental health (p = 0.029). Additionally, at 60 months after the intervention, the Sum of the psychological component (MCS) and Sum of the physical component (PCS) scores were significantly higher in the OAR group (p = 0.040 and p = 0.039, respectively). Conclusions: In the short term, patients treated for AAA by EVAR or OAR showed similar results on the SF-36 questionnaire. In the long term, patients treated by EVAR had lower scores on the physical function, vitality and mental health scales.

Quality of Life for Patients Receiving Elective Interventions for Abdominal Aortic Aneurysms

“…The content validity of the SF-36 has been compared with that of other widely used generic health surveys [ 19 , 20 ]. Systematic comparisons indicate that the SF-36 includes the eight most frequently measured health concepts; however, there are other health areas, such as sleep adequacy, cognitive functioning and sexual functioning, that are not included in the questionnaire.…”

Innovation in pathogenesis and management of aortic aneurysm

“…The surgical process involved in open thoracoabdominal repair, characterized by midline transabdominal or retroperitoneal incisions, aortic, and iliac artery clamping, is considered one of the most invasive procedures. But contrary to belief, an open approach is not inferior and is effective, and durable in terms of the graft integrity with preservation of the renal function, even in patients with increased cardiovascular risk[ 75 - 77 ]. An approach to prevent complications during the surgery using a left heart bypass (LHB) which is a circulatory support system used to perfuse the distal aorta during TAAA operation.…”