[Quality of life following heart valve prosthesis]

The subjective and objective health status of 69 patients with a mean age of 58 +/- 9 years was evaluated 2-4 years after replacement of the aortic or mitral valve. All findings were compared to the preoperative status. Subjectively, 80% of all patients felt a considerable improvement following surgery and the mean NYHA functional class dropped postoperatively from 2.68 +/- 0.63 to 1.32 +/- 0.53 (p less than 0.001). 66% of all patients felt better mentally as well. However, 64% of all patients indicated that their intellectual capacity had decreased postoperatively. Objectively the signs of congestive heart failure had decreased significantly (edema -50%, rales -83%, neck vein distention -87%). Cardiomegaly and redistribution had improved in 77% and 80% of all patients, and left ventricular hypertrophy on ECG had disappeared in 46% of all cases. Despite this important subjective and objective improvement, there was little change in the degree of postoperative employment. Thus, valve surgery leads to a dramatic subjective and objective improvement of cardiac performance and quality of life. However, the improvement has little influence on postoperative resumption of work. Results of this study also suggest that cardiac surgery has a negative effect on intellectual capacity.