[Quality of life after homograft aortic valve replacement and reoperation].

AIM

To evaluate quality of life (QoL) in patients after aortic homograft implantation for aortic valve disease and in those who had undergone reoperation due to homograft dysfunction.

METHODS

QoL was assessed in 354 patients (72 women and 282 men, mean age 55.1 +/- 11.5 years, range 13-69) after aortic homograft implantation. Patients were divided into two groups: I--patients after aortic homograft implantation without reoperation (291 patients) and II--patients after reoperation (68 patients). We used two questionnaires: SF 36 (Short Formulation 36) and a self-developed questionnaire for patients after cardiac operation (SDQ). SF 36 has three levels: a) 36 items; b) eight scales: physical activity, social activity, limitations in every day activity, body pain, mental health, emotional problems, vitality and health perception; c) two summary measures that aggregate scales; general physical health which constitutes of physical activity, limitations in every day activities, body pain, health perception and general mental health which constitutes the rest of four scales: social activity, mental health, emotional problems, vitality. Each scale is standardized from 1 to 100 with > 50 indicating better than general population average. SDQ is focused on social and demographic factors, clinical symptoms before and after operation, risk factors and physical and occupational activity.

RESULTS

By SF 36, only health perception was below general population average. We found a statistically positive relationship between QoL and high physical and occupational activity in both groups (p<0.05). The presence of dyspnea, chest pain, palpitations, edema, faints, fear/anxiety and hypertension were related to decreased general physical and mental health in both groups (p<0.05).

CONCLUSIONS

Patients after aortic homograft implantation have high QoL. This holds also for those after reoperation for homograft dysfunction. Symptomatic patients have lower QoL. Higher QoL is associated with physical and occupational activity. There is no difference in general physical health in both groups. General mental health is decreased in reoperated patients. Since reoperated patients more often suffer from emotional problems, they may particularly benefit from the psychological support.