Quality of life in patients over 70 years of age after heart valve replacement.

BACKGROUND

Previous studies on valve replacement in patients over 70 years of age have been concerned with early and long-term outcome. Little is known, however, of the quality of life (QOL) of survivors following surgery.

METHODS

Thirty-one consecutive patients, mean age 74.0+/-3.1 years, who underwent heart valve replacement were reviewed and questioned as to their physical and social activities before and after surgery and compared with 75 patients aged less than 70 years old who underwent similar procedures during the same time interval. QOL was measured by using the Rosser distress and disability scores.

RESULTS

Hospital mortality in the elderly group was the same as in the younger group (9.7% vs 2.7%, p = 0.121). Median 5-year survival was 79% in the elderly group and 92% in the younger group (p = 0.068). Overall morbidity due to valve-related complications was 3.55%/patient-year in the elderly group and 2. 35%/patient-year in the younger group, and freedom from all valve-related complications at 5 years was 76%, and 83%, respectively (p = 0.202). There were significant improvements in the distress and disability scores postoperatively (mean interval: 32. 4+/-20.4 months). The QOL value rose from 0.960 to 0.981 in the elderly group (p = 0.0004), and from 0.975 to 0.984 in the younger group (p = 0.07), suggesting that the magnitude of improvement in the elderly group was superior to that in the younger group.

CONCLUSIONS

Heart valve replacement in patients over the age of 70 years was associated with reasonable early and mid-term morbidity. We believe that significant improvements in the symptoms, functional status, and QOL of the patients can be expected.