Quality of Life and NYHA Class 30 Years after Mechanical Aortic Valve Replacement

Objective (1) To evaluate the quality of life (QoL) scores, assessed with SF36 and EuroQol (EQ-5D), of long term survivors after mechanical aortic valve replacement (mAVR); (2) to study the association of QoL with NYHA score, number of major bleeding and thrombo-embolic events and follow-up time; (3) to compare QoL scores of long term mAVR survivors with QoL scores of other populations. Methods In total 312 patients had a mAVR between 1964 and 1974 at St. Antonius Hospital Nieuwegein (NL). Mean age at operation was 41 ( sd = 12). Mean postoperative NYHA class at 1-year follow-up was 1.7 ( sd = 0.7). In 2001 the survivors ( n = 78; 25%) were followed-up for late events, NYHA class and QoL scores. 69 patients (93%) returned completed questionnaires. Results Mean duration of follow-up was 30 years ( sd = 1.8). Mean age of responders was 65 years ( sd = 10, range 47–93). In 2001, NYHA class of responders was 2 ( sd = 0.9). The mean (sd) SF36 scores for responders were: 64 (29) for physical function. 64 (29) for role-physical, 80 (30) for bodily pain. 55 (25) for general health, 63 (23) for vitality. 73 (29) for social functioning, 70 (38) for role-emotional, 76 (18) for mental health. The mean EQ-5D score of responders was: 61 (13). These SF36 and EQ-5D scores are comparable to those of other populations (e.g. cancer, diabetes type-2, migraine, chronic liver disease and iliac artery occlusive disease and Dutch general population). For responders a moderate to high association of SF36 and EQ-5D scores and their NYHA scores(R 2 = 0.36) was found. The number of major bleeding events, age, sex and survival time were not related to QoL. Conclusion At long term follow-up (mean 30 years) of patients who had mAVR, QoL was relatively high; it was moderately to highly associated with their NYHA class; bleeding and thromboembolic events seem to be of little importance for the QoL at long term follow-up. QoL at long term follow-up of patients who had mAVR is comparable to other cross sectional designed studies with short term follow-up and other population.