Life after transcatheter aortic valve implantation: quality still matters

Transcatheter aortic valve implantation (TAVI) is a relatively new technology rapidly gaining clinical acceptance for treatment of severe symptomatic aortic stenosis. Thus far the procedure has been primarily limited to patients at prohibitive or high surgical risk who are thus not candidates for traditional open-heart surgery.1 2 Subsequently, patients accepted for TAVI are a unique and previously understudied cohort, with multiple other significant co-morbidities which form the basis for failure to be accepted as surgical candidates in the first place. It is of particular interest, therefore, to determine whether despite the presence of such co-morbidities, if quality of life (QOL) can still be improved when the additive effect of severe aortic stenosis is rectified. In this issue of Heart , Gotzmann et al provide some encouraging data concerning this subject ( see page 1102 ).3 Forty-four patients undergoing TAVI using the Medtronic CoreValve bioprosthesis (Medtronic, Minneapolis, MN, USA) were followed up for 30 days, with significant improvements noted in QOL, New York Heart Association (NYHA) functional class, distance in the 6-minute walk test and B-type natriuretic peptide (BNP) levels. QOL was assessed using the Minnesota living with heart failure questionnaire (MLHFQ). There was an overall improvement in …