Postoperative Quality of Life Improvement: TAVI vs. Mini-sternotomy Tissue Valve Insertion in elderly patients with significant aortic stenosis

Achoimre

Background: Postoperative improvements in the quality of life represent a master scale for procedural success, particularly in elderly patients with cardiac conditions. Objectives: To detect positive changes in quality of life for elderly candidates with significant calcific aortic stenosis treated by aortic tissue valve insertion, either through TAVI or mini-sternotomy AVR. Patients and methods: A prospective study was done on 88 patients above 65 years with severe calcific aortic stenosis. They sought treatment at the National Heart Institute in Cairo, Egypt between March 2020 and July 2022. All patients underwent aortic tissue valve replacement. Eight candidates were removed from the study as they did not complete the follow-up period due to death or due to other reasons. 40 patients had Trans-catheter aortic valve implantation (TAVI) and the other 40 had surgical AVR through a minimally invasive approach (mini-sternotomy AVR). The study assessed the quality of life of all participants using the [RAND 36-Item Health Survey version 1.0 Questionnaire]. This was performed a day pre and three months postoperatively. Data were collected and compared. Results: Patients who underwent the TAVI procedure showed significant positive changes in physical task difficulties (15.03 ± 9.76 vs. 6.32 ± 7.21; P< 0.001), emotional task difficulties (15.05 ± 11.95 vs. 9.18 ± 6.04; P=0.007), and mental health outcomes (0.99 ± 10.43 vs. 10.45 ± 15.23; P< 0.001) compared to those who underwent surgical mini-AVR. However, the two groups had no significant differences as regards the pain scores, level of vitality, social and physical functions, and degrees of general health before and after surgery. Conclusion: Early scores of quality of life regarding patients who received TAVI were noticeably better than those who underwent mini-AVR.