Surgical vs. transcatheter aortic valve replacement in patients over 75 years with aortic stenosis: sociodemographic profile, clinical characteristics, quality of life and functionality

PeerJ. 2023 Sep 20:11:e16102. doi: 10.7717/peerj.16102. eCollection 2023.

Abstract

Background: Aortic valve stenosis (AVS) affects 25% of the population over 65 years. At present, there is no curative medical treatment for AVS and therefore the surgical approach, consisting of transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR), is the treatment of choice.

Methodology: The aim of this study was to analyze the sociodemographic and clinical characteristics, quality of life and functionality of a sample of patients with AVS over 75 years of age, who underwent TAVR or SAVR, applying standard clinical practice. A prospective multicenter observational study was conducted in two hospitals of the Spanish National Health System. Data were collected at baseline, 1, 6 months and 1 year.

Results: In total, 227 participants were included, with a mean age of 80.6 [SD 4.1]. Statistically significant differences were found in terms of quality of life, which was higher at 1 year in patients who underwent SAVR. In terms of functionality, SAVR patients obtained a better score (p < 0.01). However, patients who underwent TAVR began with a worse baseline situation and managed to increase their quality of life and functionality after 1 year of follow-up.

Conclusion: The individualized choice of TAVR or SAVR in patients with AVS improves patients' quality of life and function. Moreover, the TAVR procedure in patients with a worse baseline situation and a high surgical risk achieved a similar increase in quality of life and functionality compared to patients undergoing SAVR with a better baseline situation.

Keywords: Aortic stenosis; Aortic valve stenosis; Functionality; Quality of life; Transcatheter valve interventions; Valve disease surgery.

Publication types

  • Observational Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Aortic Valve Stenosis* / epidemiology
  • Heart Valve Prosthesis Implantation* / methods
  • Humans
  • Prospective Studies
  • Quality of Life
  • Transcatheter Aortic Valve Replacement* / methods
  • Treatment Outcome

Grants and funding

This work was supported by the Fundación Instituto de Investigación Marqués de Valdecilla (IDIVAL) (Next-Val Program). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.