Key result
Transfemoral TAVI resulted in significantly more frequent perioperative health status improvement (90.3%, P=0.004) and better 1-year MLHFQ scores (P=0.004) compared to surgical methods.
Why the study?
Does transfemoral TAVI improve quality of life compared to surgical aortic valve replacement methods in patients with symptomatic severe aortic stenosis?
Cohort (n=173)
Does transfemoral TAVI improve quality of life compared to surgical aortic valve replacement methods in patients with symptomatic severe aortic stenosis?
Answers are grounded in this paper and cite their sources.
TAVI provides superior early and 1-year quality of life improvements compared to surgical aortic valve replacement in patients with severe aortic stenosis, though differences resolve by 24 months.
OBJECTIVES: Transcatheter aortic valve implantation (TAVI) and minimally invasive aortic valve replacement (mini-thoracotomy, mini-sternotomy, MIAVR) have become an appealing alternative to conventional surgical (SAVR) treatment of severe aortic stenosis (AS) in high-risk patients. BACKGROUND: Aim of the study was to evaluate the quality of life (QoL) in patients with AS and treated with transfemoral TAVI, SAVR, mini-thoracotomy and mini-sternotomy. METHODS: One hundred and seventy-three patients with symptomatic AS were enrolled in 2011-2013. TAVI group consisted of 39 patients (22.5%), mini-sternotomy was performed in 44 patients (25.5%), mini-thoracotomy in 50 (29%), and AVR in 40 patients (23%). QoL was assessed perioperatively, 12 and 24 months after aortic valve replacement (AVR) by Minnesota Living with Heart Failure Questionnaire (MLHFQ) and EQ-5D-3L. RESULTS: Median follow-up was 583.5 (IQR: 298-736) days. Improvement of health status after procedure in comparison with pre-operative period was significantly more often reported after TAVI in perioperative period (90.3%; P = 0.004) and 12 months after procedure (100%, P = 0.02). Global MLHFQ, physical and emotional dimension score at 30-day from AVR presented significant improvement after TAVI in comparison with surgical methods (respectively: 8.3(±8.6), P = 0.003; 4.1(±5.9), P = 0.01; 1.5(±2.6), P = 0.005). Total MLHFQ score was significantly lower (better outcome) in TAVI patients 1 year after procedure (4.8(±6.8), P = 0.004), no differences in somatic and emotional component were found. No differences were found in MLHFQ score 24 months after AVR. Data from EQ-D5-3L questionnaire demonstrated significant improvement of QoL at 30-day follow-up after TAVI in comparison with surgical methods (1.2(±1.7), P = 0.0008). CONCLUSIONS: TAVI improves QoL in perioperative and 12 months observation in comparison with mini-thoracotomy, mini-sternotomy and SAVR. Improvement in QoL was obtained in both generic and disease specific questionnaires.
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Tokarek et al. (2016) conducted a cohort in symptomatic aortic stenosis (n=173). Transfemoral TAVI vs. Surgical methods (SAVR, mini-thoracotomy, mini-sternotomy) was evaluated on Quality of life assessed by Minnesota Living with Heart Failure Questionnaire (MLHFQ) and EQ-5D-3L (p=0.004). Transfemoral TAVI resulted in significantly more frequent perioperative health status improvement (90.3%, P=0.004) and better 1-year MLHFQ scores (P=0.004) compared to surgical methods.
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