Tokarek Tomasz, Siudak Zbigniew, Dziewierz Artur, Sobczyński Robert, Zasada Wojciech, Sorysz Danuta, Olszewska-Wityńska Katarzyna, Bryniarski Krzysztof, Krawczyk-Ożóg Agata, Żabówka Anna, Sadowski Jerzy, Dudek Dariusz
Department of Interventional Cardiology at University Hospital, Jagiellonian University Medical College in Krakow, Poland.
2nd Department of Cardiology, Jagiellonian University Medical College in Krakow, Poland.
Catheter Cardiovasc Interv. 2016 Sep;88(3):E80-8. doi: 10.1002/ccd.26400. Epub 2016 Jan 23.
Transcatheter aortic valve implantation (TAVI) and minimally invasive aortic valve replacement (mini-thoracotomy, mini-sternotomy, MIAVR) have become an appealing alternative to conventional surgical (SAVR) treatment of severe aortic stenosis (AS) in high-risk patients.
Aim of the study was to evaluate the quality of life (QoL) in patients with AS and treated with transfemoral TAVI, SAVR, mini-thoracotomy and mini-sternotomy.
One hundred and seventy-three patients with symptomatic AS were enrolled in 2011-2013. TAVI group consisted of 39 patients (22.5%), mini-sternotomy was performed in 44 patients (25.5%), mini-thoracotomy in 50 (29%), and AVR in 40 patients (23%). QoL was assessed perioperatively, 12 and 24 months after aortic valve replacement (AVR) by Minnesota Living with Heart Failure Questionnaire (MLHFQ) and EQ-5D-3L.
Median follow-up was 583.5 (IQR: 298-736) days. Improvement of health status after procedure in comparison with pre-operative period was significantly more often reported after TAVI in perioperative period (90.3%; P = 0.004) and 12 months after procedure (100%, P = 0.02). Global MLHFQ, physical and emotional dimension score at 30-day from AVR presented significant improvement after TAVI in comparison with surgical methods (respectively: 8.3(±8.6), P = 0.003; 4.1(±5.9), P = 0.01; 1.5(±2.6), P = 0.005). Total MLHFQ score was significantly lower (better outcome) in TAVI patients 1 year after procedure (4.8(±6.8), P = 0.004), no differences in somatic and emotional component were found. No differences were found in MLHFQ score 24 months after AVR. Data from EQ-D5-3L questionnaire demonstrated significant improvement of QoL at 30-day follow-up after TAVI in comparison with surgical methods (1.2(±1.7), P = 0.0008).
TAVI improves QoL in perioperative and 12 months observation in comparison with mini-thoracotomy, mini-sternotomy and SAVR. Improvement in QoL was obtained in both generic and disease specific questionnaires. © 2016 Wiley Periodicals, Inc.
经导管主动脉瓣植入术（TAVI）和微创主动脉瓣置换术（微创开胸术、微创胸骨切开术、MIAVR）已成为高危患者严重主动脉瓣狭窄（AS）传统外科治疗（SAVR）的一种有吸引力的替代方案。
本研究的目的是评估接受经股动脉TAVI、SAVR、微创开胸术和微创胸骨切开术治疗的AS患者的生活质量（QoL）。
2011年至2013年纳入173例有症状的AS患者。TAVI组39例（22.5%），44例行微创胸骨切开术（25.5%），50例行微创开胸术（29%），40例行AVR（23%）。通过明尼苏达心力衰竭生活问卷（MLHFQ）和EQ-5D-3L在围手术期、主动脉瓣置换术（AVR）后12个月和24个月评估QoL。
中位随访时间为583.5（IQR：298 - 736）天。与术前相比，TAVI术后围手术期健康状况改善的报告显著更频繁（90.3%；P = 0.004），术后12个月（100%，P = 0.02）。与手术方法相比，TAVI术后30天的总体MLHFQ、身体和情感维度评分有显著改善（分别为：8.3（±8.6），P = 0.003；4.1（±5.9），P = 0.01；1.5（±2.6），P = 0.005）。术后1年TAVI患者的总MLHFQ评分显著更低（结果更好）（4.8（±6.8），P = 0.004），在躯体和情感成分方面未发现差异。AVR术后24个月的MLHFQ评分无差异。EQ-D5-3L问卷数据显示，与手术方法相比，TAVI术后30天随访时QoL有显著改善（1.2（±1.7），P = 0.0008）。
与微创开胸术、微创胸骨切开术和SAVR相比，TAVI在围手术期和12个月观察期内改善了QoL。在通用和疾病特异性问卷中均获得了QoL的改善。©2016威利期刊公司
