Quality of Life of Patients Treated by Valve-Sparing Aortic Root Replacement

Abstract

The aim. To determine the effectiveness of David valve-preserving operation in comparison with Bentall operation based on the analysis of patients' quality of life after operations. Materials and methods. The study included 107 patients who underwent planned and urgent surgical treatment at the Heart Institute of the Ministry of Health of Ukraine from 2015 to 2023. The patients were divided into two groups depending on the type of surgical intervention: group A consisted of 53 patients (49,11±1,54 years; 47 (88,68%) males), who underwent the David procedure (valve-sparing replacement of aortic root and ascending aorta), group B – 55 patients (52,36±1,56 years; 53 (96,36%) males), who underwent Bentall surgery (replacement of the valve, root and ascending part of the aorta). The quality of life was assessed before the operation for each group, and in the long-term period after operation. The quality of life of the patients of both groups was compared. It was assessed using the Medical Outcomes Study Short Form 36 (MOS SF-36) questionnaire. Results. The obtained data indicated that the average preoperative values of quality of life indicators of patients of both groups with different types of aneurysm correction were significantly different from ideal health. The performed operations significantly improved the assessment of the quality of life. When comparing the quality of life in the remote period of the patients of both groups, the indicators were significantly better in group A. We noticed that the patients of group A had a significantly better psycho-social component, which probably influenced the assessment of other scales. Group A patients had statistically better all indicators of quality of life after surgery comparing with group B patients. Group B patients complained about the sound of the artificial aortic valve prosthesis, sometimes the occurrence of minor nosebleeds and the need for frequent visits of the doctor to monitor blood "thinning" indicators. Conclusions. The obtained results indicate a positive change in the quality of life in patients of both groups. When David operation is performed for aortic root and ascending aortic aneurysms, the quality of life is significantly better than in patients after Bentall operation. We recommend performing David operations at the highly specialized cardiac centers.