Health-related quality of life following transcatheter aortic valve implantation using transaortic, transfemoral approaches and surgical aortic valve replacement-a single-center study.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Severe symptomatic aortic stenosis (n=97). Intervention: Transcatheter aortic valve implantation (TAVI) vs. Surgical aortic valve replacement (SAVR). Primary outcome: EQ-5D-3L index value at 1 year (p=<0.05).

Aleksandra Stańska; Dariusz Jagielak; Maciej Michał Kowalik; Maciej Brzeziński; Rafał Pawlaczyk; Jadwiga Fijałkowska; Wojciech Karolak; Jan Rogowski; Peter Bramlage

doi:10.11909/j.issn.1671-5411.2018.11.002

November 1, 2018Open Access

Health-related quality of life following transcatheter aortic valve implantation using transaortic, transfemoral approaches and surgical aortic valve replacement-a single-center study.

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Key result

Transcatheter aortic valve implantation (transaortic and transfemoral) improved quality of life at one year, with patients reporting higher health status than those undergoing surgical aortic valve replacement.

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Why the study?

Does transcatheter aortic valve implantation (TAVI) improve health-related quality of life compared to surgical aortic valve replacement (SAVR) in elderly patients with severe symptomatic aortic stenosis?

Study Design

Type

Observational (n=97)

Randomization

None

Multicenter

No

Structured PICO

Does transcatheter aortic valve implantation (TAVI) improve health-related quality of life compared to surgical aortic valve replacement (SAVR) in elderly patients with severe symptomatic aortic stenosis?

P

Population

97 elderly patients (mean age 80 years, 65% female) with severe symptomatic aortic stenosis undergoing transcatheter or surgical aortic valve replacement, followed for one year.

I

Intervention

Transcatheter aortic valve implantation (TAVI) using either transaortic (TAo, n=32) or transfemoral (TF, n=31) approach.

C

Comparator

Surgical aortic valve replacement (SAVR) performed under general anesthesia using a median sternotomy (n=34).

O

Outcome

Health-related quality of life (QoL) assessed using the EQ-5D-3L questionnaire index value and Visual Analogue Scale (VAS) at 1 month and 1 year.patient reported

Main Result

p-value: p=<0.05

Limitations

Single-center study with a small sample size.
Lack of an aortic stenosis-specific quality of life questionnaire, relying on the general EQ-5D-3L.
High one-year mortality associated with TAVI may lead to survivor bias as the proportion of patients with available data diminishes over time.
Single center
Small sample size
Lack of an aortic stenosis-specific QoL questionnaire
Survivor bias due to high 1-year mortality in TAVI patients

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Implication

TAVI via both transfemoral and transaortic approaches provides a greater improvement in health-related quality of life at 1 year compared to surgical aortic valve replacement in elderly patients with severe aortic stenosis.

Abstract

OBJECTIVE: To evaluate short- and long-term changes in quality of life (QoL) in patients undergoing transcatheter aortic valve implantation (TAVI) and to assess differences in patient QoL when using the TAVI transaortic (TAVI TAo) approach compared with the transfemoral approach (TAVI TF) and surgical aortic valve replacement (SAVR). METHODS: Ninety-seven patients were assessed. Thirty-two patients underwent TAVI TAo, 31 underwent TAVI TF and 34 patients underwent SAVR. QoL was assessed using the EQ-5D-3L questionnaire at baseline, after one month and one year. In all groups, the values significantly increased after one-month and one-year of follow-up in comparison to baseline value. Significant differences were also demonstrated between Visual Analogue Scale values (VAS). CONCLUSIONS: A significant improvement in QoL was observed in all three patient groups. Regardless of the TAVI approach, EQ-5D-3L and VAS values were significantly increased after one-month and one-year follow up; the SAVR patients however, reported lower health status when compared to the TAVI patients.

Discussion

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Cite This Study

Stańska et al. (2018) conducted an observational in Severe symptomatic aortic stenosis (n=97). Transcatheter aortic valve implantation (TAVI) vs. Surgical aortic valve replacement (SAVR) was evaluated on EQ-5D-3L index value at 1 year (p=<0.05). Transcatheter aortic valve implantation (transaortic and transfemoral) improved quality of life at one year, with patients reporting higher health status than those undergoing surgical aortic valve replacement.

synapsesocial.com/papers/6a20bf4aad6bf63344e74a35 https://doi.org/10.11909/j.issn.1671-5411.2018.11.002

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Health-related quality of life following transcatheter aortic valve implantation using transaortic, transfemoral approaches and surgical aortic valve replacement-a single-center study.

Figures

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Health-related quality of life following transcatheter aortic valve implantation using transaortic, transfemoral approaches and surgical aortic valve replacement-a single-center study.

Figures

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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