Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan 1;50(1):e217659.
doi: 10.14503/THIJ-21-7659.

Transcatheter Aortic Valve Replacement for Severe Aortic Valve Stenosis: Do Patients Experience Better Quality of Life Regardless of Gradient?

Anthony Simone  1   2 , Juka S Kim  1 , Jeanne Huchting  1 , Asim Rafique  1 , Ruhsen Ozcaglayan  1 , Richard J Shemin  3 , Olcay Aksoy  1 , Murray H Kwon  3
Affiliations

Transcatheter Aortic Valve Replacement for Severe Aortic Valve Stenosis: Do Patients Experience Better Quality of Life Regardless of Gradient?

Anthony Simone et al. Tex Heart Inst J. .

Abstract

Background: Aortic valve replacement improves survival for patients with low-gradient aortic valve stenosis, but there is a paucity of data on postoperative quality of life for this population.

Methods: In a single-center retrospective analysis of 304 patients with severe aortic valve stenosis who underwent transcatheter aortic valve replacement, patients were divided into 4 groups based on mean pressure gradient, left ventricular ejection fraction, and stroke volume index. Using the Kansas City Cardiomyopathy Questionnaire-12, quality of life was assessed immediately before and 1 month after transcatheter aortic valve replacement.

Results: Most patients in the low-flow, low-gradient group were men; this group had higher relative rates of cardiovascular disease and type 2 diabetes than the paradoxical low-flow, low-gradient group; the normal-flow, low-gradient group; and the high-gradient group. All-cause mortality did not differ significantly among the groups at 1 month after surgery, and all groups experienced a significant improvement in quality-of-life scores after surgery. The mean improvement was 27 points in the low-flow, low-gradient group, 25 points in the paradoxical low-flow, low-gradient group, 30 points in the normal-flow, low-gradient group, and 30 points in the high-gradient group (all P < .001).

Conclusion: Quality of life improves significantly across all subgroups of aortic valve stenosis after trans-catheter aortic valve replacement, regardless of flow characteristics or aortic valve gradients.

Keywords: Aortic valve stenosis; quality of life; surveys and questionnaires; transcatheter aortic valve replacement.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosure: Dr Murray H. Kwon and Dr Richard J. Shemin are paid consultants of Edwards Lifesciences.

Figures

Fig. 1
Fig. 1
All 4 subgroups of severe AS show a dramatic shift in NYHA class distribution 1 month after TAVR, with very few patients falling into class III or IV after valve replacement. Statistical comparisons use the McNemar-Bowker test, with P < .05 considered statistically significant. AS, aortic valve stenosis; HG-AS, high-gradient aortic valve stenosis; LFLG-AS, low-flow, low-gradient aortic valve stenosis; NFLG-AS, normal-flow, low-gradient aortic valve stenosis; NYHA, New York Heart Association; pLFLG-AS, paradoxical low-flow, low-gradient aortic valve stenosis; TAVR, transcatheter aortic valve replacement.
See this image and copyright information in PMC

References

    1. Eveborn GW, Schirmer H, Heggelund G, Lunde P, Rasmussen K. The evolving epidemiology of valvular aortic stenosis. the Tromsø study. Heart . 2013;99(6):396–400. doi: 10.1136/heartjnl-2012-302265. - DOI - PubMed
    1. Clavel MA, Magne J, Pibarot P. Low-gradient aortic stenosis. Eur Heart J . 2016;37(34):2645–2657. doi: 10.1093/eurheartj/ehw096. - DOI - PMC - PubMed
    1. Reardon MJ, Van Mieghem NM, Popma JJ, et al. SURTAVI Investigators Surgical or transcatheter aortic-valve replacement in intermediate-risk patients. N Engl J Med . 2017;376(14):1321–1331. doi: 10.1056/NEJMoa1700456. - DOI - PubMed
    1. Gleason TG, Reardon MJ, Popma JJ, et al. CoreValve U.S Pivotal High Risk Trial Clinical Investigators. 5-year outcomes of self-expanding transcatheter versus surgical aortic valve replacement in high-risk patients. J Am Coll Cardiol . 2018;72(22):2687–2696. doi: 10.1016/j.jacc.2018.08.2146. - DOI - PubMed
    1. Clavel MA, Fuchs C, Burwash IG et al. Predictors of outcomes in low-flow, low-gradient aortic stenosis: results of the multicenter TOPAS study. Circulation . 2008;118(14 suppl):S234–S242. doi: 10.1161/CIRCULATIONAHA.107.757427. - DOI - PubMed