Quality of Life in Patients Aged 60-65 Years Receiving Mechanical versus Bioprosthetic Aortic Valve Replacement

Abstract

Background: For patients eligible for both mechanical and bioprosthetic valves, postoperative quality of life (QOL) is a key factor in determining the type of prosthetic valve used.

Methods: We reviewed patients aged 60-65 years who underwent isolated aortic valve replacement at our centre. Postoperative QOL was assessed through a telephone follow-up using the 36-item Short Form Health Survey questionnaire.

Results: A total of 628 valid survey responses were collected, comprising 353 patients with mechanical valves and 275 with bioprosthetic valves. The mean age of the patients was 62.5 ± 1.7 years, and 363 (57.8%) were men. The mean follow-up period was 7.3 ± 3.9 years. There were no significant differences in any QOL subscale or the overall 36-item Short Form Health Survey score between patients with mechanical and bioprosthetic valves. BMI (β=-0.109, p=0.014) and postoperative time (β=-0.251, p<0.001) were the independent predictors of QOL, after adjusting for factors, such as age at the time of surgery, sex, ejection fraction, type of prosthesis and prosthesis effective orifice area index. The rates of stroke and cardiovascular reintervention per patient-year were similar between the two groups. However, in those 12 years after aortic valve replacement, mechanical valves seemed to perform better.

Conclusion: In patients aged 60-65 years undergoing isolated aortic valve replacement, there is no significant difference in postoperative QOL between those receiving mechanical or bioprosthetic valves, but mechanical valves seemed to perform better in the late period.

Keywords: 36-item Short Form Health Survey; Aortic valve replacement; bioprosthetic valve; mechanical valve; quality of life.

Figure 1:. Survival Following Mechanical and Bioprosthetic Aortic Valve Replacement