Quality of life after aortic valve replacement

Understanding the quality of life after aortic valve replacement has become increasingly important. As aortic valve replacement numbers increase, more patients, physicians and families are affected by the subsequent quality of life. Quality of life information can inform the decision to perform aortic valve replacement and the selection of replacement valve. When reviewing quality of life results, it is important to realize that the findings are affected by the selection and quality of instruments, as many studies have not used valid or reliable instruments. Studies have shown that aortic valve replacement appears to significantly improve the quality of life of survivors, including those older than 70 years of age and even decades after the procedure, quality of life remains high. Studies have suggested that the elderly may gain as much quality of life benefit as younger patients. No consistent differences in resulting total quality of life have been observed between mechanical and bioprosthetic valves. Only one study showed some quality of life benefits of pulmonary autograft over mechanical valves. It is unclear whether minimally invasive aortic valve replacements confer better quality of life than standard aortic valve replacements. While existing quality of life studies have provided important information, more studies are needed especially as valve technology and operative techniques continue to improve. Future studies should endeavor to use validated general and disease-specific instruments and quantify the effects of demographics, preoperative clinical conditions and intraoperative variables on quality of life outcomes.