Title:Improvement in Quality of Life in Old People with Aortic Stenosis after Transcatheter Aortic Valve Implantation
VOLUME: 9 ISSUE: 3
Author(s):Yue Li, Wei Guo, Tao Zhang, Jie Liu, Senhao Jia, Xiaoping Liu and Xin Jia
Affiliation:Department of Vascular Surgery, Clinical Division of Surgery, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
Keywords:Aortic valve stenosis, elderly, follow-up, quality of life, transcatheter aortic valve implantation.
Abstract:Background: This study aimed to compare the improvement in the quality of life (QoL) in
the long-term follow-up of 12 to 24 months after transcatheter aortic valve implantation (TAVI)
therapy for old people with severe aortic stenosis.
Methods: According to the guidelines provided by PRISMA, published studies till 15 June, 2014 were
retrieved from Google Scholar, Pubmed, Embase and CNKI. Health-related QoL was evaluated at
beginning and at 12 to 24 months with five kinds of instruments. Funnel plots were used to test the
potential publication bias, and analyze the source of heterogeneity, such as meta-regression, subgroup
and sensitivity.
Results: Our meta-analysis involved ten studies with 1359 patients. Preprocedural summary 12-item Short Form (SF-12)
physical and mental scores showed a significant improvement after one year after TAVI [weighted mean difference
(WMD): -10.61, 95% confidence interval (CI): -15.06, -6.15; WMD: -6.39, 95%CI: -9.08, -3.70; respectively]. One year
follow-up visit after TAVI revealed significantly improved QoL compared to baseline in Kansas City Cardiomyopathy
Questionnaire (KCCQ) and EuroQol (EQ-5D) (WMD: -29.44, 95%CI: -33.29, -26.58; WMD: -0.09, 95%CI: -0.12, -0.06;
respectively). At 12 to 24 months, weighted mean 36-item Short-Form (SF-36) physical improved by 16.96 points
(95%CI: -27.77, -6.16) and SF-36-mental improved by 5.57 points (95%CI: -9.96, -1.19); weighted mean Minnesota
Living with Heart Failure Questionnaire (MLHFQ) decreased by 22.29 points (95%CI: 16.09, 28.48).
Conclusion: This technique provides a promising therapy approach for old patients with severe symptomatic aortic
stenosis in high-risk surgery, and there are significant improvements for this group in health-related quality of life in the
follow-up.
