[Quality of life after aortic valve-replacement in patients > or = 75 years]

A growing number of elderly undergo surgery of the aortic valve. It is therefore important to investigate their postoperative course concerning quality of life.

A questionnaire was designed and distributed, which retrospectively illustrated quality of life pre- and postoperatively in a cohort consisting of 124 patients aged >or= 75 years extracted from the Western Danish Cardiac Database. All patients were operated at Department T, Odense University Hospital in the period 2003-2005. All had a prosthetic aortic valve inserted without any concomitant procedure. Cause and date of death was obtained from death certificates. The median follow-up was 43 month (range: 36-72).

The patients' well-being generally showed an increase of 35% following surgery. Social interactions were enhanced in 10% of the cohort. After surgery, 14% stated that they now had a good level of physical activity, 1% expressed good energy level and 6% greater joy. The study showed a slight increase in the need for help for everyday life. The patients' New York Heart Association (NYHA) class was improved in 25%, unchanged in 60% and worsened in 15% of patients. Regarding the patients' own expectations to the outcome, 49% stated "as expected", 37% "better" and 14% "worse than expected". The distribution on housing types showed only moderate variation from the background population. The late mortality rate corresponded to that of the age-matched background population.

Postoperatively, an improved quality of life was found in the majority of patients >or= 75 years who had undergone aortic valve surgery, and long-term survival was not affected. Hence, it is justified to perform this type of surgery in the elderly.