TAVI Boosts Real-World Quality of Life (CME/CE)
The current study included 102 patients getting TAVI at a single institution over a 2-year period from 2008 to 2010.
Criteria for the procedure were a peak velocity of flow over 4 m/s or a calculated aortic valve area under 0.8 cm 2 in a symptomatic patient deemed unsuitable for surgical valve replacement due to high risk or comorbidities that precluded operation.
When measured with a variety of quality-of-life questionnaires, patients showed the following improvements from baseline to 30 days post procedure: Physical functioning (27.8 versus 33.6, P <0.001) Role physical (31.8 versus 35.8, P =0.006) Bodily pain (38.9 versus 45.9, P<0.001) General health (33.4 versus 40.3, P <0.001) Vitality (36.8 versus 41.2, P =0.006) Mental health (45.2 versus 48.5, P =0.027)
Compared with the 30-day scores, quality of life further improved at 6 months for the following: Physical functioning, to 36.5 ( P <0.001) Role physical, to 39.3 ( P <0.001) Vitality, to 43 ( P =0.002)
Bodily pain and general health-related quality of life didn't continue to rise but stayed higher than baseline ( P =0.02 and P <0.001).
Social functioning and role emotional subscales also improved at both points, although not significantly so.
At 1 year, there was an across-the-board decline compared with 6 months, though no component of quality of life fell significantly.
The benefits for physical functioning, role physical, general health, and vitality remained significant compared with baseline ( P <0.001 to P =0.03).
The same pattern held for a summary score of physical health, rising from 29.5 at baseline to 36.3 at 30 days and to 38.3 at 6 months (both P <0.001), and then declining to 34.4 at 1 year, though still significant at a P -value of 0.02 versus baseline.
"The small drop in reported health between 6 months and 1 year, which although statistically insignificant, may reflect a decline in health that could become significant over a longer time period," the researchers cautioned.
Predictors of better health-related quality of life outcomes after TAVI were male sex and being treated by a more experienced operator ( P =0.01 and P <0.05).