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The effect of aortic valve replacement on quality of life in symptomatic patients with severe aortic stenosis

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Abstract

Background

Although symptomatic patients with severe aortic stenosis have a high disease burden and guidelines recommend aortic valve replacement, many are treated conservatively. This study describes to what extent quality of life is changed by aortic valve replacement relative to conservative treatment.

Methods

This observational study followed 132 symptomatic patients with severe aortic stenosis who were subjected to an SF-36v2TM Health Survey.

Results

At baseline 84 patients were treated conservatively, 48 were referred for aortic valve replacement. In the conservatively treated group 15 patients died during a mean follow-up of 18 months (Kaplan-Meier survival was 85 % and 72 % at one and 2 years respectively) and 22 patients crossed over to the surgical group. Of the resulting 70 patients in the surgical group 3 patients died during a mean follow-up of 11 months (survival 95 % at 1 year). Physical functioning, vitality and general health improved significantly 1 year after aortic valve replacement. In conservatively treated patients physical quality of life deteriorated over time while general health, vitality and social functioning showed a declining trend. Mental health remained stable in both groups.

Conclusions

Aortic valve replacement improves physical quality of life, general health and vitality in patients with symptomatic severe aortic stenosis. Besides having a low life expectancy, conservatively treated patients experience deterioration of physical quality of life. Health surveys such as the SF-36v2TM can be valuable tools in monitoring the burden of disease for an individual patient and offer additional help in treatment decisions.

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Acknowledgments

The authors would like to thank the patients, cardiologists, echo laboratory staff and secretaries of the following hospitals for their kind cooperation: Havenziekenhuis, Rotterdam; St. Franciscus Gasthuis, Rotterdam; IJsselland Hospital, Capelle aan den Ijssel; Vlietland Hospital, Vlaardingen; Albert Schweitzer Hospital, Dordrecht; Medisch Centrum Rijnmond Zuid, Rotterdam; and Erasmus University Medical Center, Rotterdam.

Disclosures

The authors have no disclosures to make.

Author information

Authors and Affiliations

  1. Department of Cardio-thoracic Surgery, Catharina Hospital, PO Box 1350, 5602 ZA, Eindhoven, the Netherlands

    M. W. A. van Geldorp

  2. Department of Cardio-thoracic Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands

    M. W. A. van Geldorp, H. J. Heuvelman, A. P. Kappetein, J. J. M. Takkenberg & A. J. J. C. Bogers

  3. Department of Medical Psychology and Psychotherapy, Erasmus University Medical Center, Rotterdam, the Netherlands

    J. J. V. Busschbach

Authors
  1. M. W. A. van Geldorp
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  2. H. J. Heuvelman
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  3. A. P. Kappetein
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  4. J. J. V. Busschbach
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  5. J. J. M. Takkenberg
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  6. A. J. J. C. Bogers
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Corresponding author

Correspondence to M. W. A. van Geldorp.

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van Geldorp, M.W.A., Heuvelman, H.J., Kappetein, A.P. et al. The effect of aortic valve replacement on quality of life in symptomatic patients with severe aortic stenosis. Neth Heart J 21, 28–35 (2013). https://doi.org/10.1007/s12471-012-0362-y

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  • DOI: https://doi.org/10.1007/s12471-012-0362-y

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