Quality of life in 3875 patients after Transcatheter Aortic Valve Implantation
1-year-data from the German Aortic Valve Registry
Deutsches Aortenklappenregister
German Aortic Valve RegistrY
EACTS 2014 Milan
R. Lange, A. Beckmann, T. Neumann, M. Krane, R. Zahn, J. Cremer, W.
Hamm, F.W. Mohr
on behalf of the GARY Registry
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Deutsches Aortenklappenregister
German Aortic Valve RegistrY
Executive Board Steering Committee
joint project
German Society of Thoracic and Cardiovascular Surgery
German Society of Cardiology
supported by:
German Heart Foundation
Agreement of participation
data managment
Informed consent
hospitals
patients
EQ-5Dimension – 3 Level
Best
imaginable health status
= 100%
Worst
imaginable health status
= 0%
Visual analogue scale (VAS)
Quality of Life Measurement
EQ-5D – 3 Level and VAS
no complains mild complains severe complains
http://www.euroqol.org/fileadmin/user_upload/Documenten/PDF/Produc ts/Sample_UK__English__EQ-5D-3L.pdf
Best
imaginable health status
= 100%
Worst
imaginable health status
= 0%
4
X X
X
X
X
X
X
X
X
X X
X
Pre-OP – 1-Year-FU
Quality of Life Measurement
EQ-5D – 3 Level and VAS/pre-OP and 1-year FU
Included patients
Patient distribution
N=14220
included patients 01/01/2011 – 31/12/2011
N=360 Ross OP/David OP
N=3875
TAVI (TV and TA)
N=6523 SAVR
N=3462 SAVR+CABG
N=2694
TAVI - TV
N=1181
TAVI - TA
53 cardiac surgery units 69 cardiology units
1 year follow-up: 3875 patients
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Parameter TAVI-TV
(n=2694)
TAVI-TA (n=1181)
EQ-5D (pre OP) 2553 (94.8%) 1136 (96.2%)
EQ-5D (1-year FU) 1782 (66.1%) 715 (60.5%)
FU denied 98 (3.6%) 32 (2.7%)
Patient alive (national population register) 179 (6.6%) 74 (6.3%)
1-year mortality 565 (21%) 328 (27.8%)
lost to FU 70 (2.6%) 32 (2.7%)
Preoperative patient
characteristics
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Procedural Patient
characteristics
Postoprative Patient
characteristics
VAS Score
Changes: pre-OP 1-year-FU
pre-OP 1-year FU
V A S score (%)
48 50 52 54 56 58 60
TAVI_TV TAVI_TA
p<0.001 p<0.001
EQ-5D – 3 Level
Changes: pre-OP 1-year-FU
no complains mild complains severe complains
Difference pre-OP/1-year FU (%)
TAVI-TV
7,6
-6,4
-1,2
-10 -8 -6 -4 -2 0 2 4 6 8
10
TAVI-TA
3,5
-3,8
0,3
-10 -8 -6 -4 -2 0 2 4 6 8 10
Mobility
12
EQ-5D – 3 Level
Changes: pre-OP 1-year-FU
no complains mild complains severe complains
Difference pre-OP/1-year FU (%)
TAVI-TV TAVI-TA
Results from
The German Heart Center
physical summary score
mental summary score
pre TAVI
3 months post TAVI 12 months post TAVI
Krane et al, 2010, AHJ
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Summary
GARY provides a large study population with completed follow-up
improved VAS Scores in both groups with higher values in TAVI-TV
Treatment of aortic valve disease by TAVI leads to significant improvement of QoL shown by:
increased patient numbers in the EQ-5D dimensions mobility and usual activity within Level I
The dimensions pain/discomfort and depression/anxiety showed significant increases for patient numbers in the Level III reflecting a worsening of QoL in these dimensions
The limited improvement of QoL after TAVI within mental score groups like pain/discomfort and depression/anxiety is a reported phenomenon in TAVI patients.
Thank you!
EACTS Advanced Course on the Mitral and Tricuspid Valves at the
German Heart Center Munich
German Heart Center Munich
