Quality of life in octogenarians after valve replacement due to aortic stenosis: A prospective comparison with younger patients

BACKGROUND: Results of aortic valve surgery in octogenarians have been evaluated as event-free survival. However, little attention has been given to quality of life aspects. METHODS: Thirty-two consecutive patients, mean age 83 +/- 2 years, undergoing valve replacement due to aortic stenosis, were compared to 30 patients, mean age 71 +/- 3 years, undergoing the same procedure. Mortality, morbidity and quality of life were studied. An interview was performed before surgery and 3 and 12 months postoperatively. The questionnaire contained items related to self-rated health, symptoms, physical ability, sleep disturbances and social and emotional functioning. RESULTS: Pre-operatively the older patient group was in a worse condition with a higher NYHA functional class and a more pronounced cardiomegaly. They had more cardiac symptoms and were more depressed. The control group had a higher score for physical ability and rated their quality of life as better. Postoperatively there was a higher early mortality rate in the octogenarians (9% vs 0%; ns). After 3 months, improvement of functional status and relief of symptoms was observed in both groups. Physical ability improved and the depression score decreased significantly in both groups. Self-rated health and quality of life improved. One year after valve replacement the improvement in quality of life was of a similar magnitude in the two groups. CONCLUSION: Following aortic valve replacement, octogenarians, despite a more compromised pre-operative status showed an improvement in symptomatology, physical ability and general well being, of a similar magnitude to that of the younger patients group. These findings lend further support to the recommendation that valve replacement should be performed in octogenarians with symptomatic aortic stenosis.