Bento Dina, Coelho Pedro, Lopes João, Fragata José
Serviço de Cardiologia, Centro Hospitalar Universitário do Algarve, Faro, Portugal.
Serviço de Cirurgia Cardiotorácica, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisboa, Portugal.
Rev Port Cardiol (Engl Ed). 2019 Apr;38(4):251-258. doi: 10.1016/j.repc.2018.06.011. Epub 2019 May 20.
Aortic stenosis (AS) is the most common valvular disease in the elderly, affecting around 8.1% by the age of 85, with a negative impact on quality of life.
To determine the impact of surgical aortic valve replacement (SAVR) on quality of life in octogenarians.
In a single-center retrospective study of octogenarians undergoing isolated SAVR for symptomatic AS between 2011 and 2015, quality of life was assessed using the Medical Outcomes Study Short Form (SF-36) at baseline and at three, six and 12 months after surgery. Scores for the eight domains and two components of the SF-36 were compared at baseline and in the postoperative period by one-way analysis of variance.
Over a five-year period, 163 octogenarians underwent SAVR, of whom 3.1% died in the hospital. Deceased patients and those who did not complete the SF-36 were excluded. A total of 81 patients were included, mean age 83±2 years, 63% female, 60.5% in NYHA class II or higher and 19.7% with left ventricular systolic dysfunction. The mean logistic EuroSCORE was 10.7±5.1%. In the hospital, 1.2% suffered stroke, 1.2% received a permanent implantable pacemaker and 23.5% presented atrial fibrillation. In the assessment of quality of life, improvement was seen in all SF-36 domains (p<0.002) and in the physical component (p<0.001) at three, six and 12 months compared to baseline. The mental component also showed improvement, which was significant at six months (p=0.011).
SAVR improved the physical and mental health status of octogenarians with severe AS. This improvement was evident at three months and consistent at six and 12 months.
主动脉瓣狭窄（AS）是老年人中最常见的瓣膜疾病，85岁时发病率约为8.1%，对生活质量有负面影响。
确定外科主动脉瓣置换术（SAVR）对八旬老人生活质量的影响。
在一项单中心回顾性研究中，对2011年至2015年间因症状性AS接受单纯SAVR的八旬老人进行研究，在基线以及术后3个月、6个月和12个月时使用医学结局研究简表（SF - 36）评估生活质量。通过单因素方差分析比较基线和术后时期SF - 36八个领域和两个组成部分的得分。
在五年期间，163名八旬老人接受了SAVR，其中3.1%在医院死亡。排除死亡患者和未完成SF - 36的患者。共纳入81例患者，平均年龄83±2岁，63%为女性，60.5%为纽约心脏协会（NYHA）II级或更高级别，19.7%伴有左心室收缩功能障碍。平均逻辑欧洲心脏手术风险评估系统（EuroSCORE）为10.7±5.1%。在医院中，1.2%发生中风，1.2%接受了永久性植入式心脏起搏器，23.5%出现房颤。在生活质量评估中，与基线相比，术后3个月、6个月和12个月时SF - 36的所有领域（p<0.002）和身体组成部分（p<0.001）均有改善。心理组成部分也显示出改善，在6个月时具有显著性（p = 0.011）。
SAVR改善了重度AS八旬老人的身心健康状况。这种改善在3个月时明显，在6个月和12个月时持续存在。
