A Cirurgia de Substituição Valvular Aórtica Melhora a Qualidade de Vida dos Octogenários com Estenose Aórtica Severa

• Autor(a) principal: Bento, D
• Data de Publicação: 2019
• Outros Autores: Coelho, P, Lopes, J, Fragata, J
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.17/3996
• topic: HSM CCT; Age Factors; Aged, 80 and over; Aortic Valve / diagnostic imaging; Aortic Valve / surgery*; Aortic Valve Stenosis / diagnosis; Aortic Valve Stenosis / mortality; Aortic Valve Stenosis / surgery*; Echocardiography; Female; Male; Humans; Follow-Up Studies; Health Surveys / methods; Portugal / epidemiology; Quality of Life; Retrospective Studies; Risk Factors; Severity of Illness Index; Survival Rate / trends; Transcatheter Aortic Valve Replacement / methods*

Introduction: Aortic stenosis (AS) is the most common valvular disease in the elderly, affecting around 8.1% by the age of 85, with a negative impact on quality of life. Objective: To determine the impact of surgical aortic valve replacement (SAVR) on quality of life in octogenarians. Methods: In a single-center retrospective study of octogenarians undergoing isolated SAVR for symptomatic AS between 2011 and 2015, quality of life was assessed using the Medical Outcomes Study Short Form (SF-36) at baseline and at three, six and 12 months after surgery. Scores for the eight domains and two components of the SF-36 were compared at baseline and in the postoperative period by one-way analysis of variance. Results: Over a five-year period, 163 octogenarians underwent SAVR, of whom 3.1% died in the hospital. Deceased patients and those who did not complete the SF-36 were excluded. A total of 81 patients were included, mean age 83±2 years, 63% female, 60.5% in NYHA class II or higher and 19.7% with left ventricular systolic dysfunction. The mean logistic EuroSCORE was 10.7±5.1%. In the hospital, 1.2% suffered stroke, 1.2% received a permanent implantable pacemaker and 23.5% presented atrial fibrillation. In the assessment of quality of life, improvement was seen in all SF-36 domains (p<0.002) and in the physical component (p<0.001) at three, six and 12 months compared to baseline. The mental component also showed improvement, which was significant at six months (p=0.011). Conclusion: SAVR improved the physical and mental health status of octogenarians with severe AS. This improvement was evident at three months and consistent at six and 12 months.