Quality of life improvement is maintained up to two years after transcatheter aortic valve implantation in high-risk surgical candidates

Aims: The aim of the study was to investigate the changes in quality of life (QoL) following transcatheter aortic valve implantation (TAVI) up to two years' follow-up. Methods and results: One hundred consecutive patients (46 females, mean age 79.7±6.1 years) with at least two years' follow-up who underwent TAVI in our institution, between November 2007 and September 2009, were enrolled in this study. Peak and mean aortic gradients were 87.8±25.8 mmHg and 53.3±15.4 mmHg, respectively. Mean log EuroSCORE was 27.9±15.9. Patients had multiple comorbidities. All patients underwent a standardised prospective screening pathway, including QoL evaluation with the 36-item short-form health survey (SF-36v2®) and the Minnesota Living with Heart Failure Questionnaires (MLHFQ). The scores obtained preoperatively were compared with those obtained at two years' follow-up. An Edwards SAPIEN valve (Edwards Lifesciences, Irvine, CA, USA) was implanted in 67 patients (55 transfemoral and 12 transapical) and a CoreValve (Medtronic, Inc., Minneapolis, MN, USA) was implanted in 33 patients (26 transfemoral and seven transaxillary). Thirty-day mortality was 4%. Actuarial survival was 80.6±4.1%, 72.6±4.7% and 63.2±6.3% at one, two and three years, respectively. Mean SF36-physical improved from 31.9±8.8 to 51.5±9.5 (p<0.0001) and SF36-mental improved from 44.7±11.6 to 49.5±8.6 (p=0.0002). Mean MLHFQ decreased from 41.5±14.5 to 15.9±13.7 (p<0.0001). QoL score changes were not influenced by age or comorbidities. Conclusions: TAVI in high-risk surgical candidates is associated with favourable short and long-term survival and with improvement of QoL up to two years after the procedure.