Surgical aortic valve replacement improves the quality of life of octogenarians with severe aortic stenosis

Abstract

Introduction: 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.

Objective: To determine the impact of surgical aortic valve replacement (SAVR) on quality of life in octogenarians.

Methods: 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.

Results: 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).

Conclusion: 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.

Keywords: Aortic stenosis; Aortic valve surgery; Cirurgia valvular aórtica; Estenose aórtica; Octogenarian; Octogenário; Qualidade de vida; Quality of life; SF‐36; SF‐36..