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Quality of life after aortic valve surgery: Replacement versus reconstruction

2011; Elsevier BV; Volume: 142; Issue: 2 Linguagem: Inglês

10.1016/j.jtcvs.2011.02.006

1097-685X

Diana Aicher, Annika Holz, Susanne K. Feldner, Volker Köllner, Hans‐Joachim Schäfers,

Cardiac Structural Anomalies and Repair

ObjectiveQuality of life has been shown to be influenced by aortic valve replacement, particularly in younger patients. Aortic valve repair is a recent alternative to replacement. We investigated quality of life and anxiety and depression after aortic valve repair and compared with 2 established replacement alternatives, mechanical valve and pulmonary autograft.MethodsIn a cross-sectional study, 166 patients (age, 18–45 years) were studied after isolated elective aortic valve surgery. They had undergone aortic valve repair (group I, n = 86), replacement with mechanical prosthesis (group II, n = 41), or pulmonary autograft (group III, n = 39). Assessment was performed by Short Form Health Survey, Hospital Anxiety and Depression Scale, Cardiac Anxiety Questionnaire, and valve-specific questions.ResultsIn Short Form Health Survey, groups I and III revealed similar or identical scores better than group II in physical functioning (P = .02), general health (P = .03), and mental health (P = .05). No differences were found in Hospital Anxiety and Depression Scale score. In cardiac anxiety, there was less heart-focused attention in groups I and III than in group II (P = .043, P = .053). In response to valve-specific questions, there were no differences between groups I and III. Interestingly, fear of reoperation was identical in all 3 groups.ConclusionsIn young patients after aortic valve surgery quality of life is influenced by type of operation. Although differences are limited, aortic valve reconstruction and pulmonary autograft replacement lead to less long-term alteration from normal values. Quality of life has been shown to be influenced by aortic valve replacement, particularly in younger patients. Aortic valve repair is a recent alternative to replacement. We investigated quality of life and anxiety and depression after aortic valve repair and compared with 2 established replacement alternatives, mechanical valve and pulmonary autograft. In a cross-sectional study, 166 patients (age, 18–45 years) were studied after isolated elective aortic valve surgery. They had undergone aortic valve repair (group I, n = 86), replacement with mechanical prosthesis (group II, n = 41), or pulmonary autograft (group III, n = 39). Assessment was performed by Short Form Health Survey, Hospital Anxiety and Depression Scale, Cardiac Anxiety Questionnaire, and valve-specific questions. In Short Form Health Survey, groups I and III revealed similar or identical scores better than group II in physical functioning (P = .02), general health (P = .03), and mental health (P = .05). No differences were found in Hospital Anxiety and Depression Scale score. In cardiac anxiety, there was less heart-focused attention in groups I and III than in group II (P = .043, P = .053). In response to valve-specific questions, there were no differences between groups I and III. Interestingly, fear of reoperation was identical in all 3 groups. In young patients after aortic valve surgery quality of life is influenced by type of operation. Although differences are limited, aortic valve reconstruction and pulmonary autograft replacement lead to less long-term alteration from normal values.