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Clinical research

Improvement of physical and mental health after transfemoral transcatheter aortic valve implantation

1. Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, University of Bern, Bern, Switzerland; 2. Department of Cardiovascular Surgery, Swiss Cardiovascular Center Bern, Bern University Hospital, University of Bern, Bern, Switzerland

Aims: Transcatheter aortic valve implantation (TAVI) has emerged as a treatment alternative to surgical aortic valve replacement in elderly high-risk patients with symptomatic severe aortic stenosis. In this patient population, rapid improvement or restoration of quality of life (QoL) is at least as important as improved clinical outcomes. The purpose of the present study was to assess changes in QoL in response to TAVI.

Methods and results: Between August 2007 and August 2010, 62 patients (39% females, age 83±5years) underwent TAVI and were included in this QoL study. QoL was impaired at baseline and improved in all components of physical and mental health at nine months of follow-up: physical functioning (37.0 to 59.0, p<0.0001), physical role functioning (18.3 to 49.1, p<0.0001), general health (55.9 to 64.9, p=0.001), vitality (40.7 to 51.3, p<0.001), social functioning (67.4 to 76.8, p=0.049), emotional functioning (52.0 to 75.8, p<0.001) and mental health (66.6 to 75.8, p=0.05). The subscale bodily pain (60.7 to 70.4, p=0.058) showed a strong trend to improvement, but failed to reach statistical significance. Besides changes in health-related QoL, TAVI significantly improved symptoms (NYHA class 2.6±0.8 to 1.4±0.6, p<0.0001).

Conclusions: TAVI leads to rapid and sustained restoration of all aspects of mental and physical health and effectively alleviates symptoms.

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