scholarly journals Quality of life after aortic valve replacement with biological prostheses in elderly patients

2017 ◽  
Vol 21 (3) ◽  
pp. 40 ◽  
Author(s):  
D. P. Demidov ◽  
D. A. Astaspov ◽  
A. V. Bogachev-Prokophiev ◽  
S. I. Zheleznev
Keyword(s):  
Quality Of Life ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Elderly Patients ◽  
Valve Replacement ◽  
Conflict Of Interest ◽  
Group I ◽  
Biological Prostheses

<p><strong>Aim.</strong> The paper aims to assess the quality of life of patients subjected to aortic valve replacement with a stented/stentless biological prosthesis. <br /><strong>Methods.</strong> The research was done at the Acquired Heart Disease Department of Meshalkin National Medical Research Center. The inclusion criteria were patient age older than 65 years and severe stenosis of the aortic valve. 114 patients were randomized 1:1 in two groups: group I patients received stentless biological prostheses, while group II patients — stented xenopericardial ones. All patients underwent aortic valve replacement under normothermic cardiopulmonary bypass. Mean follow-up was 3.9 [2.77; 4.55] years, mean age 71.5±4 (65–84) years, mean left ventricle ejection fraction 65.5 (40–86) % and mean preoperative Log.Euroscore 5.4±1.3 (1.4–12.4). The quality of life was assessed by using a standard questionnaire SF-36.<br /><strong>Results.</strong> Peak transprosthetic gradients at 1-year follow-up amounted to 16.22±4.34 and 24.66±4.74 mm Hg for group I and group II respectively. The 5-year survival rate was 90 [81; 99] % and 96 [90; 100] % for the two groups respectively and did not differ statistically (log rank test, p = 0.226). A statistically significant improvement of quality of life among patients in both groups was observed at 1-year follow-up, as compared to the preoperative values, however, marked intergroup differences in any of the parameters were not recorded.<br /><strong>Conclusion.</strong> The quality of life after aortic valve replacement with stented and stentless biological prostheses in elderly patients confirms clinical and functional efficiency of both methods, does not show sound advantages of any of them and improves both the physical component of health and subjective emotional level.</p><p>Received 25 July 2017. Revised 18 August 2017. Accepted 28 August 2017.</p><p><strong>Funding:</strong> The study was carried out with the support of a grant of the President of the Russian Federation (МД–6967.2016.7) created to provide government assistance to the leading research centers in Russian Federation.</p><p><strong>Conflict of interest:</strong> The authors declare no conflict of interest.</p>

scholarly journals Deformational dynamics of the aortic root in elderly patients after aortic valve replacement with biological prostheses

2017 ◽  
Vol 21 (4) ◽  
pp. 31
Author(s):  
D. P. Demidov ◽  
D. A. Astaspov ◽  
A. V. Bogachev-Prokophiev ◽  
S. I. Zheleznev ◽  
A. M. Karaskov
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Elderly Patients ◽  
Valve Replacement ◽  
Conflict Of Interest ◽  
Aortic Root ◽  
Group I ◽  
Stentless Bioprostheses ◽  
Biological Prostheses

<p><strong>Aim.</strong> The study was designed to comparatively assess dynamic changes of the aortic root structures depending on a phase of the cardiac cycle in patients with degenerative aortic stenosis, who underwent aortic valve replacement with different types of biological prostheses.<br /><strong>Methods.</strong> This prospective parallel controlled randomized trial study was performed at Meshalkin National Medical Research Center over a period from 2011 to 2015. The inclusion criteria were severe aortic stenosis and patients’ age older than 65 years. 114 patients were randomized 1:1 in two groups: group I included 57 patients with stentless biological prostheses, while group II (control one) consisted of 57 patients with stented xenopericardial prostheses. The average age was 71 [66; 74] and 72 [69; 77] for the first and second groups, respectively (p = 0.054). All patients underwent aortic valve replacement. The operation was performed under standard normothermic cardiopulmonary bypass. The diameter of the implanted prostheses was 25 mm [24; 26] and 23 mm [21; 23] for the first and second groups, respectively (p = 0.375). An ECG-synchronized CT study of the aortic root was carried out in the postoperative period.<br /><strong>Results.</strong> An intergroup systolic/diastolic difference in the values of the cross-sectional area of the aortic root at all levels was observed in patients with stentless bioprostheses, while the control group patients (with stented bioprostheses) had no such difference at the levels of the left ventricle output tract and the fibrous ring of the aortic valve.<br /><strong>Conclusion.</strong> A stentless design of bioprostheses retains the deformational and elastic properties of the aortic root in elderly patients with aortic valve stenosis after surgical treatment.</p><p>Received 5 December 2017. Revised 12 December 2017. Accepted 15 December 2017.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> The authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and study design: D.P. Demidov, D.A. Astapov, A.V. Bogachev-Prokophiev<br />Data collection and analysis: D.P. Demidov<br />Drafting the article: D.P. Demidov<br />Critical revision of the article: D.A. Astapov, A.V. Bogachev-Prokophiev<br />Final approval of the version to be published: D.A. Astapov, A.V. Bogachev-Prokophiev, S.I. Zheleznev, A.M. Karaskov</p>

scholarly journals Exercise Hemodynamics and Quality of Life after Aortic Valve Replacement for Aortic Stenosis in the Elderly Using the Hancock II Bioprosthesis

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Theodore Long ◽  
Becky M. Lopez ◽  
Christopher Berberian ◽  
Mark J. Cunningham ◽  
Vaughn A. Starnes ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Elderly Patients ◽  
Valve Replacement ◽  
Functional Classification ◽  
Age Related ◽  
Sf 36

Background and Aim. While aortic valve replacement for aortic stenosis can be performed safely in elderly patients, there is a need for hemodynamic and quality of life evaluation to determine the value of aortic valve replacement in older patients who may have age-related activity limitation.Materials and Methods. We conducted a prospective evaluation of patients who underwent aortic valve replacement for aortic stenosis with the Hancock II porcine bioprosthesis. All patients underwent transthoracic echocardiography (TTE) and completed the RAND 36-Item Health Survey (SF-36) preoperatively and six months postoperatively.Results. From 2004 to 2007, 33 patients were enrolled with an average age of 75.3 ± 5.3 years (24 men and 9 women). Preoperatively, 27/33 (82%) were New York Heart Association (NYHA) Functional Classification 3, and postoperatively 27/33 (82%) were NYHA Functional Classification 1. Patients had a mean predicted maximumVO2(mL/kg/min) of 19.5 ± 4.3 and an actual maxVO2of 15.5 ± 3.9, which was 80% of the predictedVO2. Patients were found to have significant improvements (P≤0.01) in six of the nine SF-36 health parameters.Conclusions. In our sample of elderly patients with aortic stenosis, replacing the aortic valve with a Hancock II bioprosthesis resulted in improved hemodynamics and quality of life.

Does patient–prosthesis mismatch after aortic valve replacement affect survival and quality of life in elderly patients?

2016 ◽  
Vol 17 (2) ◽  
pp. 137-143 ◽  
Author(s):  
Elena Sportelli ◽  
Tommaso Regesta ◽  
Antonio Salsano ◽  
Paola Ghione ◽  
Carlotta Brega ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Elderly Patients ◽  
Valve Replacement ◽  
Patient Prosthesis Mismatch

scholarly journals Heart Team for Optimal Management of Patients with Severe Aortic Stenosis—Long-Term Outcomes and Quality of Life from Tertiary Cardiovascular Care Center

2021 ◽  
Vol 10 (22) ◽  
pp. 5408
Author(s):  
Szymon Jonik ◽  
Michał Marchel ◽  
Ewa Pędzich-Placha ◽  
Zenon Huczek ◽  
Janusz Kochman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Heart Team ◽  
Secondary Endpoints

Background: This retrospective study was proposed to investigate outcomes of patients with severe aortic stenosis (AS) after implementation of various treatment strategies following dedicated Heart Team (HT) decisions. Methods: Primary and secondary endpoints and quality of life during a median follow-up of 866 days of patients with severe AS qualified after HT discussion to: optimal medical treatment (OMT) alone, OMT and transcather aortic valve replacement (TAVR) or OMT and surgical aortic valve replacement (SAVR) were evaluated. As the primary endpoint composite of all-cause mortality, non-fatal disabling strokes and non-fatal rehospitalizations for AS were considered, while other clinical outcomes were determined as secondary endpoints. Results: From 2016 to 2019, 176 HT meetings were held, and a total of 482 participants with severe AS and completely implemented HT decisions (OMT, TAVR and SAVR for 79, 318 and 85, respectively) were included in the final analysis. SAVR and TAVR were found to be superior to OMT for primary and all secondary endpoints (p < 0.05). Comparing interventional strategies only, TAVR was associated with reduced risk of acute kidney injury, new onset of atrial fibrillation and major bleeding, while the superiority of SAVR for major vascular complications and need for permanent pacemaker implantation was observed (p < 0.05). The quality of life assessed at the end of follow-up was significantly better for patients who underwent TAVR or SAVR than in OMT-group (p < 0.05). Conclusions: We demonstrated that after careful implementation of HT decisions interventional strategies compared to OMT only provide superior outcomes and quality of life for patients with AS.

Long-Term Survival, Autonomy, and Quality of Life of Elderly Patients Undergoing Aortic Valve Replacement

2011 ◽  
Vol 27 (1) ◽  
pp. 20-23 ◽  
Author(s):  
Sílvia Marta Oliveira ◽  
Ana Sofia Correia ◽  
Mariana Paiva ◽  
Alexandra Gonçalves ◽  
Marta Pereira ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Elderly Patients ◽  
Valve Replacement ◽  
Term Survival ◽  
Long Term Survival

Quality of Life After Aortic Valve Replacement at the Age of >80 Years

Circulation ◽  
2000 ◽  
Vol 102 (suppl_3) ◽  
Author(s):  
Thoralf M. Sundt ◽  
Marci S. Bailey ◽  
Marc R. Moon ◽  
Eric N. Mendeloff ◽  
Charles B. Huddleston ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Functional Outcome ◽  
Renal Dysfunction ◽  
Valve Replacement ◽  
Hospital Length Of Stay ◽  
Perioperative Stroke ◽  
Late Survival

Background —The optimal management of aortic valve disease in patients >80 years old depends on functional outcome as well as operative risks and late survival. Methods and Results —We retrospectively identified 133 patients (62 men, 71 women) aged 80 to 91 years (mean 84±3 years) who underwent aortic valve replacement alone or in combination with another procedure between January 1, 1993, and April 31, 1998. Demographics included hypertension 68%, diabetes mellitus 17%, and history of stroke 11%. Operative (30 day) mortality rate was 11%. Urgent or emergent surgery, aortic insufficiency, and perioperative stroke or renal dysfunction were risk factors for operative death by multivariable analysis. Intensive care unit and total hospital length of stay were prolonged at 6.2 and 14.7 days, respectively. Late follow-up between July 1, 1998, and November 1, 1999, was 98% complete. Actuarial survival at 1 and 5 years was 80% and 55%, respectively. Predictors of late mortality were preoperative or perioperative stroke, chronic obstructive pulmonary disease, aortic stenosis, and postoperative renal dysfunction. The mean New York Heart Association functional class for 65 long-term survivors improved from 3.1 to 1.7. Quality of life assessed with the Medical Outcomes Study Short Form-36 was comparable to that predicted for the general population >75 years old. Conclusions —Functional outcome after aortic valve replacement in patients >80 years old is excellent, the operative risk is acceptable, and the late survival rate is good. Surgery should not be withheld from the elderly on the basis of age alone.

Sign in / Sign up

Export Citation Format

Share Document