The impact of surgical aortic valve replacement on quality of life—a multicenter study

Blokzijl, Fredrike; Houterman, Saskia; Straten, Bart H.M. van; Daeter, Edgar J.; Bruinsma, George J. Brandon Bravo; Dieperink, Willem; Reneman, Michiel F.; Keus, Frederik; Horst, Iwan C. C. van der; Mariani, Massimo A.

doi:10.1016/j.jtcvs.2019.09.184

Cited by 15 publications

(12 citation statements)

References 30 publications

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“…In a more selected group of high-risk patients with an indication for either surgical aortic valve replacement or transcatheter aortic valve implantation, an absence in increased physical performance at 6-months was as high as 58.7% [19]. Our data do not confirm age as independent risk factor, as previously reported in the setting of elective CABG and aortic valve replacement [20,21]. This may be due to differences in inclusion criteria (our study also reports on non-elective surgery patients) or the fact that age was included in our multivariate model as a continuous, rather than a categorical variable.…”

Section: Discussioncontrasting

confidence: 60%

Determinants of non-recovery in physical health-related quality of life one year after cardiac surgery: a prospective single Centre observational study

Jong

Haenen

Raap

et al. 2020

J Cardiothorac Surg

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Background: Recent studies show that substantial percentage of patients experienced worsening of health related quality of life (HRQoL) 1 year after cardiac surgery. The aim of this study is to identify risk factors that interfere with improvement of HRQoL. Methods: From December 2015 till July 2017 a prospective single centre observational study was carried out in 1920 patients participated who underwent non-salvage cardiac surgery. All patients were requested to complete a Short Form 36 (SF-36) questionnaire before and 1 year after surgery. Primary aim of the study was to identify risk factors for non-recovery in the physical domain of the SF-36 in all cardiac surgery patients. Secondary aim was to identify identical risk factors in patients with isolated coronary artery bypass grafting. Results: After cardiac surgery, the questionnaires for physical and mental health were completed by respectively 803 and 807 patients. Median age was 69[62-75] years, and 77% was male. In comparison to the preoperative status, 176 patients (21.9%) did not display an improvement in the SF-36 physical domain score 1 year after cardiac surgery. In a multivariate analysis independent risk factors for non-recovery in the SF-36 physical domain were baseline SF36 physical domain score (OR 0.954[0.942-0.965], P < 0.001), diabetes (OR 0.437 [0.265-0.720], P 0.001), female sex (OR 0.492 [0.307-0.789], P 0.003), post-operative infection (OR 0.240 [0.109-0.525], P < 0.001) and PCI within 1 year (OR 0.113 [0.036-0.349], P < 0.001) For isolated CABG, 23.2% of patients did not display an improvement in the physical domain score and risk factors appeared to be identical. Conclusions: Twenty two percent of all cardiac surgery patients did not show an improvement in the physical domain score of the HRQoL between the preoperative period and 1 year after surgery. Independent risk factors for non-recovery after cardiac surgery were baseline SF-36 physical domain score, diabetes, female sex, any postoperative infection and the need for PCI in the first year. Further research is needed to tailor the patient selection procedure prior to surgery and potentially modify risk factors in the perioperative process.

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Section: Discussioncontrasting

confidence: 60%

Determinants of non-recovery in physical health-related quality of life one year after cardiac surgery: a prospective single Centre observational study

Jong

Haenen

Raap

et al. 2020

J Cardiothorac Surg

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“…To assess the level of implementation of MCID methodology in cardiothoracic (CT) surgery, six studies were identified through the thorough literature search and were included that employed the MCID methodology to assess QoL in those patients ( Table 1 ) [ 12 , 20 , 21 , 22 , 23 , 24 ]. The first study employed anchor-based methods to calculate MCID metrics [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Another study [ 20 ] evaluated the association of surgical aortic valve replacement (SAVR) and QoL, along with the variance with age, especially for high-risk patients. This was an observational, multicenter cohort study that was conducted in accordance with the RECORD guidelines (Reporting of studies Conducted using Observational Routinely collected Data) [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Demystifying the Value of Minimal Clinically Important Difference in the Cardiothoracic Surgery Context

Magouliotis

Bareka

Rad

et al. 2023

Life

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The aim of this review is to describe the different statistical methods used in estimating the minimal clinically important difference (MCID) for the assessment of quality of life (QOL)-related and clinical improvement interventions, along with their implementation in cardiothoracic surgery. A thorough literature search was performed in three databases (PubMed/Medline, Scopus, Google Scholar) for relevant articles from 1980 to 2022. We included articles that implemented and assessed statistical methods used to estimate the concept of MCID in cardiothoracic surgery. MCID has been successfully implemented in several medical specialties. Anchor-based and distribution-based methods are the most common approaches when evaluating the MCID. Nonetheless, we found only five studies investigating the MCID in the context of cardiothoracic surgery. Four of them used anchor-based approaches, and one used both anchor-based and distribution-based methods. MCID values were very variable depending on the methods applied, as was the clinical context of the study. The variables of interest were certain QOL measuring questionnaires, used as anchors. Multiple anchors and methods were applied, leading to different estimations of MCID. Since cardiothoracic surgery is related to important perioperative morbidity, MCID might represent an important and efficient adjunct tool to interpret clinical outcomes. The need for MCID methodology implementation is even higher in patients with heart failure undergoing cardiac surgery. More studies are needed to validate different MCID methods in this context.

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“…Advancement in the diagnosis and treatment of valvular heart disease is one of the greatest medical achievements of the 20th century, one that continues to advance today. Aortic Valve Replacement (AVR), in particular, significantly improves patient quality of life (QOL) and is associated with increased survival in patients with severe aortic stenosis (AS) 1–3 . Surgical AVR (SAVR), first performed in 1967, has been used to treat millions of patients worldwide.…”

Section: Introductionmentioning

confidence: 99%

Surgical versus transcatheter aortic valve replacement: Impact of patient‐prosthesis mismatch on outcomes

Alnajar

Hamad

Azhar

et al. 2022

Journal of Cardiac Surgery

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Background The hemodynamics of most prosthetic valves are often inferior to that of the normal native valve, and a significant proportion of patients undergoing surgical (SAVR) or transcatheter aortic valve replacement (TAVR) have high residual transaortic pressure gradients due to prosthesis–patient mismatch (PPM). As the experience with TAVR has increased and long‐term outcomes are reported, a close look at the PPM literature is required in light of new evidence. Methods For this review, we searched the Embase, Medline, and Cochrane databases from 2000 to 2022. Articles reporting PPM as an outcome following aortic valve replacements were identified and reviewed. Results The impact of PPM on clinical outcomes in aortic valve replacement has not been clear as multiple studies failed to report PPM incidence. However, the PPM outcomes after SAVR vary more widely than after TAVR, ranging from 8% to 80% in SAVR and from 24% to 35% in TAVR. Incidence of severe PPM following redo SAVR ranges from 2% to 9% and following valve‐in‐valve TAVR is from 14% to 33%, however, while PPM is higher in valve‐in‐valve TAVR, patients had better survival rates. Conclusions The gap between valve performance and clinical outcomes in SAVR and TAVR could be reduced by carefully selecting patients for either treatment option. Understanding predictors of PPM can add to the safety, effectiveness, and increased survival benefit of both SAVR and TAVR.

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The impact of surgical aortic valve replacement on quality of life—a multicenter study

Cited by 15 publications

References 30 publications

Determinants of non-recovery in physical health-related quality of life one year after cardiac surgery: a prospective single Centre observational study

Determinants of non-recovery in physical health-related quality of life one year after cardiac surgery: a prospective single Centre observational study

Demystifying the Value of Minimal Clinically Important Difference in the Cardiothoracic Surgery Context

Surgical versus transcatheter aortic valve replacement: Impact of patient‐prosthesis mismatch on outcomes

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