Abstract 15348: Transcatheter Aortic Valve Replacement Improves Functional Status and Quality of Life in Elderly Patients With Severe Aortic Stenosis
Introduction: Transcatheter aortic valve replacement (TAVR) prolongs survival in high-risk patients with severe aortic stenosis. However, the functional and quality-of-life benefits of TAVR have not been well established.
Methods: We conducted a meta-analysis to evaluate the changes in functional status and quality-of-life outcomes after TAVR, in comparison with surgical aortic valve replacement (SAVR) or conservative treatment (CT). Studies of TAVR with at least 6 month follow-up and reported New York Heart Association (NYHA) class, Short-Form 12/36 physical and mental component summary scores were included. The mean change (95% confidence interval) in primary outcomes from baseline to 6-11 or 12-17 months was pooled using a random-effects model.
Results: In 52 studies including 6436 TAVR, 574 SAVR and 439 CT patients (Table), there was a significant improvement in TAVR patients: NYHA class (-1.4 [-1.5, -1.3]) at 6-11 months and -1.4 [-1.6, -1.2] at 12-17 months) (Figure), Short-Form12/36 physical component summary (9.1 [5.6, 12.6] at 6-11 months and 10.5 [5.8, 15.1] at 12 months) and mental component summary (5.6 [2.7, 8.5] and 4.7 [2.8, 6.6]). These changes were comparable to the improvement in SAVR patients: NYHA class (-1.7 [-1.8, -1.5] at 6-11 months and -0.9 [-1.7, -0.1] at 12-17 months) and Short-Form12/36 physical component summary (7.1 [5.5, 8.7 at 6-11 months and 5.7 [4.0, 7.4] at 12 months) and mental component summary (3.9 [2.1, 5.6] and 4.4 [2.6, 6.3]). However, CT did not result in any meaningful improvement.
Conclusions: Current evidence suggests the functional and quality-of-life benefits of TAVR among older patients who survive the procedure.
- © 2013 by American Heart Association, Inc.