Copyright © 1996 by the European Society of Cardiology.
© 1996 The European Society of Cardiology
Quality of life in octogenarians after valve replacement due to aortic stenosis
A prospective comparison with younger patients
*Department of cardiology, Thoracic Clinics, Karolinska Hospital Stockholm, Sweden
National Institute for Psychosocial Factors and Health, Karolinska Institute Stockholm, Sweden
Research Centre of General Medicine, Karolinska Hospital Stockholm, Sweden
Received 22 May 1995; accepted 22 June 1995.
Correspondence: Margareta Olsson MD, Department of Cardi ology, Thoracic Clinics, Karolinska Hospital, S-171 76 Stockholm, Sweden
Abstract
BACKGROUND: Results of aortic valve surgery in octogenar ians have been evaluated as event-free survival. However, little attention has been given to quality of life aspects.
METHODS: Thirty-two consecutive patients, mean age 83±2 years, undergoing valve replacement due to aortic stenosis, were compared to 30 patients, mean age 71±3 years, undergoing the same procedure. Mortality, morbidity and quality of life were studied. An interview was performed before surgery and 3 and 12 months postoperatively. The questionnaire contained items related to self-rated health, symptoms, physical ability, sleep disturbances and social and emotional functioning.
RESULTS: Pre-operatively the older patient group was in a worse condition with a higher NYHA functional class and a more pronounced cardiomegaly. They had more cardiac symptoms and were more depressed. The control group had a higher score for physical ability and rated their quality of life as better Postoperatively there was a higher early mortality rate in the octogenarians (9% vs 0% ns). After 3 months, improvement of functional status and relief of symptoms was observed in both groups. Physical ability improved and the depression score decreased significantly in both groups. Self-rated health and quality of life improved. One year after valve replacement the improve ment in quality of life was of a similar magnitude in the two groups.
CONCLUSION: Following aortic valve replacement, octogen arians, despite a more compromised pre-operative status showed an improvement in symptomatology, physical abil ity and general well being, of a similar magnitude to that of the younger patients group. These findings lend further support to the recommendation that valve replacement should be performed in octogenarians with symptomatic aortic stenosis.
Key Words: Quality of life • aortic valve replacement • octogenarians • prospective comparison
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