Quality of life and functional status of patients after autologous pericardial aortic valve reconstruction

Close metadata

OBJECTIVE

To assess the quality of life and functional status of patients in mid-term period after autologous pericardial aortic valve reconstruction.

MATERIAL AND METHODS

A prospective controlled single-center study included 71 patients after surgical treatment of aortic stenosis. Patients were divided into the following groups: group 1 (AVNeo M, n=24) — young and middle-aged patients (19—50 years) who underwent autologous pericardial neocuspidization; group 2 (AVNeo B, n=23) — older patients (51—79 years) who underwent autologous pericardial neocuspidization; group 3 (AVR, n=24) — young and middle-aged patients (26—50 years) who underwent aortic valve replacement. We analyzed functional outcomes (6-minute walk test and NYHA functional class) and quality of life (Perchinsky and SF-36 questionnaires).

RESULTS

Pericardial neocuspidization in appropriate groups was followed by the longest distance in 6-minute walk test (357±110.1, 352±101 and 248.2±89.1 m, respectively, p<0.01). The same patients demonstrated the best indicators of quality of life regarding physical functioning, physical role, body pain, general health, vitality and social functioning. According to the Perchinsky questionnaire, patients after autologous pericardial aortic valve reconstruction were more often irritated by the need for follow-up, risk of valve-associated complications, valve failure and repeated surgery. In turn, patients after AVR were dissatisfied with frequent blood tests and high risk of bleeding.

CONCLUSION

Most patients after aortic valve neocuspidization have a higher tolerance to physical activity compared to AVR. These ones are more often irritated by the need for follow-up, risk of valve-associated complications, valve failure and repeated surgery.

Keywords:

autologous pericardial neocuspidization

quality of life

functional status

Authors:

Badalyan S.S.

Sechenov First Moscow State Medical University

ORCID: 0000-0002-8246-3708

Komarov R.N.

Sechenov First Moscow State Medical University

ORCID: 0000-0002-3904-6415

Babakulova N.M.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0002-8740-9575

Ismailbaev A.M.

Sechenov First Moscow State Medical University

ORCID: 0000-0001-8545-3276

Received:

07.08.2023

Accepted:

02.10.2023

List of references:

Duran CM, Gometza B, Kumar N, Gallo R, Martin-Duran R. Aortic valve replacement with freehand autologous pericardium. Journal of Thoracic and Cardiovascular Surgery. 1995;110(2):511-516. https://doi.org/10.1016/S0022-5223(95)70248-2
Ozaki S, Kawase I, Yamashita H, Uchida S, Nozawa Y, Matsuyama T, Takatoh M, Hagiwara S. Aortic valve reconstruction using self-developed aortic valve plasty system in aortic valve disease. Interactive CardioVascular and Thoracic Surgery. 2011;12(4):550-553. https://doi.org/10.1510/icvts.2010.253682
Aicher D, Langer F, Lausberg H, Bierbach B, Schäfers HJ. Aortic root remodeling: ten-year experience with 274 patients. Journal of Thoracic and Cardiovascular Surgery. 2007;134(4):909-915. https://doi.org/10.1016/j.jtcvs.2007.05.052
Price J, De Kerchove L, Glineur D, Vanoverschelde JL, Noirhomme P, El Khoury G. Risk of valve-related events after aortic valve repair. Annals of Thoracic Surgery. 2013;95(2):606-612; discussion 613. https://doi.org/10.1016/j.athoracsur.2012.07.016
Russell SD, Saval MA, Robbins JL, Ellestad MH, Gottlieb SS, Handberg EM, Zhou Y, Chandler B; HF-ACTION Investigators. New York Heart Association functional class predicts exercise parameters in the current era. American Heart Journal. 2009;158(4 suppl):S24-30. https://doi.org/10.1016/j.ahj.2009.07.017
Bubnova MG, Persiyanova—Dubrova AL. Six-minute walk test in cardiac rehabilitation. Cardiovascular Therapy and Prevention. 2020;19(4):2561. (In Russ.). https://doi.org/10.15829/1728-8800-2020-2561
McHorney CA, Ware JE Jr, Lu JF, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Medical Care. 1994;32(1):40-66. https://doi.org/10.1097/00005650-199401000-00004
Perchinsky M, Henderson C, Jamieson WR, Anderson WN Jr, Lamy A, Lowe N, de Guzman S. Quality of life in patients with bioprostheses and mechanical prostheses. Evaluation of cohorts of patients aged 51 to 65 years at implantation. Circulation. 1998;98(19 suppl):II81-86; discussion II86-87.
Komarov RN, Ismailbaev AM, Cherniavskii SV, Dzyundzya AN, Danachev AO, Ognev OO, Lencovets MV. BioBentall procedure and autological materials in aortic root surgery. Circulation Pathology and Cardiac Surgery. 2022;26(3):9-20. (In Russ.). https://doi.org/10.21688/1681-3472-2022-3-9-20
Sa MP, Chernov I, Marchenko A, Chagyan V, Komarov R, Askadinov M, Enginoev S, Kadyraliev B, Ismailbaev A, Tcheglov M, Clavel M-A, Pibarot P, Ruhparwar A, Weymann A, Zhigalov K. Aortic valve neocuspidization (Ozaki Procedure) in patients with small aortic annulus (≤21 mm): a multicenter study. Struct Heart. 2020;4(5):413-419. https://doi.org/10.1080/24748706.2020.1792595
Zacek P, Holubec T, Vobornik M, Dominik J, Takkenberg J, Harrer J, Vojacek J. Quality of life after aortic valve repair is similar to Ross patients and superior to mechanical valve replacement: a cross-sectional study. BMC Cardiovascular Disorders. 2016;16:63. https://doi.org/10.1186/s12872-016-0236-0
Casselman FP, Gillinov AM, Akhrass R, Kasirajan V, Blackstone EH, Cosgrove DM. Intermediate-term durability of bicuspid aortic valve repair for prolapsing leaflet. European Journal of Cardio-Thoracic Surgery. 1999;15(3):302-328. https://doi.org/10.1016/s1010-7940(99)00003-2
Yacoub MH, Gehle P, Chandrasekaran V, Birks EJ, Child A, Radley-Smith R. Late results of a valve-preserving operation in patients with aneurysms of the ascending aorta and root. Journal of Thoracic and Cardiovascular Surgery. 1998;115(5):1080-1090. https://doi.org/10.1016/S0022-5223(98)70408-8
Hanke T, Charitos EI, Paarmann H, Stierle U, Sievers HH. Haemodynamic performance of a new pericardial aortic bioprosthesis during exercise and recovery: comparison with pulmonary autograft, stentless aortic bioprosthesis and healthy control groups. European Journal of Cardio-Thoracic Surgery. 2013;44(4):e295-301. https://doi.org/10.1093/ejcts/ezt367
Karaskov AM, Bogachev—Prokofiev AV, Sharifulin RM, Demin II, Zheleznev SI, Open AB, Pivkin AN. Outcomes of the Ross procedure in patients with an accompanying ascending aortic aneurysm. Angiology and Vascular Surgery. 2016;22(1):142-158. (In Russ.).

Close metadata