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Quality of life after interventions on the thoracic aorta with deep hypothermic circulatory arrest
Franz F Immer1, Eva Krähenbühl, Alexsandra S Immer-Bansi
1Department of Cardiovascular Surgery, University Hospital, 3010 Berne, Switzerland. franzimmer@yahoo.de
Objective:
Assessment of quality of life (QL) in patients undergoing major surgical procedures is of increasing interest. We focused on surgery of the thoracic aorta requiring deep hypothermic circulatory arrest (DHCA). Aim of this study was to assess QL after thoracic aortic surgery with DHCA, using the Short Form 36 Health Survey (SF-36) questionnaire.
Methods:
Between 01/94 and 12/99 212 (59.1%) out of a total of 359 interventions on the thoracic aorta were performed under DHCA, with an early mortality of 13.7% (28 patients). During an average follow-up of 3.2+/-1.3 years, 27 patients died (15.2%) and five patients (2.8%) were lost. A total of 145 patients (81.9%) had a complete follow-up.
Results:
125 of the 145 SF-36 questionnaire handed out were answered correctly (86.2%). In relation to a standard population (z=0), the most important deficits were found in physical function (z=-0.53) and role limitations because of physical health (z=-0.42). Good results were found regarding the aspect of pain (z=0.28), social functioning (z=0.02) and vitality (z=-0.02). Overall QL in patients having been operated for aortic aneurysm was better than for patients with acute type A-dissection.
Conclusion:
Despite restrictions in physical functioning and role limitation because of physical health, QL in patients after interventions on the thoracic aorta with DHCA is fairly good and, for patients being operated for aortic aneurysm, comparable to an age-matched standard population. Patients having being operated electively for aortic aneurysm enjoyed a better QL than patients having been operated emergently for acute type A dissection.