Key result
TAVR yields comparable 30-day KCCQ-12 improvements in patients with and without chronic lung disease.
Why the study?
Because symptoms of chronic lung disease and aortic stenosis frequently overlap, it is unclear whether patients with chronic lung disease experience the same quality-of-life improvement after TAVR as those without.
Does transcatheter aortic valve replacement (TAVR) improve quality of life to the same degree in patients with chronic lung disease compared to those without?
Cohort (n=238)
Does transcatheter aortic valve replacement (TAVR) improve quality of life to the same degree in patients with chronic lung disease compared to those without?
p-value: p=0.900
Patients with severe aortic stenosis and concomitant chronic lung disease experience a comparable degree of quality-of-life improvement following TAVR as those without chronic lung disease.
Supports TAVR consideration for QoL benefit in chronic lung disease; hypothesis-generating and requires prospective validation.
BACKGROUND: As the symptoms for both chronic lung disease (CLD) and aortic stenosis (AS) frequently overlap, it may be challenging to determine the degree of symptomatic improvement expected for a patient with CLD after correction of AS. Our aim was to determine if patients with CLD have the same degree of quality-of-life improvement following transcatheter aortic valve replacement (TAVR) as patients without CLD. METHODS: A retrospective review of 238 TAVR patients from January 2017 to November 2018 who underwent preoperative pulmonary function tests and completed 30-day follow-up was performed. Patients were identified as having CLD with FEV1 more than 75% predicted. Postoperative outcomes and changes in Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) were compared between groups. RESULTS: Of the 238 patients identified, 143 (60.0%) had CLD, 50 (35.0%) of whom had an obstructive disease pattern. Patients with CLD were more likely to be male, had higher rates of peripheral artery disease, and had lower baseline ejection fraction. There was no difference in STS Predicted Risk of Mortality, but patients with CLD were more likely to be designated as high-risk by surgeon evaluation. While initial and follow-up KCCQ-12 was lower for patients with CLD, there was no significant difference in degree of improvement (p = .900). When comparing patients with obstructive lung disease (FEV1/FVC < 0.70) to those without CLD, there was also no significant difference in the change of quality of life (p = .720). CONCLUSION: Although patients with concomitant severe AS and CLD have reduced baseline quality of life compared to patients without CLD, they experience a comparable degree of improvement following TAVR.
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Catalano et al. (2021) conducted a cohort in Aortic stenosis and chronic lung disease (n=238). Transcatheter aortic valve replacement (TAVR) in patients with chronic lung disease vs. TAVR in patients without chronic lung disease was evaluated on Change in Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) (p=0.900). Patients with chronic lung disease undergoing TAVR experienced a comparable degree of quality-of-life improvement on the KCCQ-12 at 30 days compared to those without chronic lung disease (p=0.900).
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