Author + information
- Meghana Helder,
- Hartzell Schaff,
- Brian Lahr,
- D. Craig Miller and
- Heidi Connolly
Valve-sparing operations (AVS) for the treatment of aortic root aneurysms in Marfan syndrome (MFS) patients (pt) are expected to provide better quality of life (QOL) compared to composite valve replacement (AVR) as valve preservation avoids chronic anticoagulation and other hazards of prostheses.
51 pt with MFS underwent either AVS or AVR from 2/11/2005-9/3/2010 at 1 institution. Pt completed SF-36 QOL questionnaires pre- and post-op at 6 mo and 1, 2, and 3 yr. The SF-36 consists of 8 subscales (physical functioning, physical role functioning, bodily pain, general health perceptions, vitality, social role functioning, emotional role functioning, and emotional well-being) that were collapsed into 2 components: Physical Component Summary and Mental Component Summary. The 10 scales were standardized to a norm value of 50. Mean change (MC, 95% confidence interval) is reported as a baseline-adjusted response via least squares estimation. Comparison of AVS and AVR groups was done with an ANCOVA model.
32 pt (age 35.2±11.8 yr; 19% female) underwent AVS, and 19 (age 40.2±15.4 yr, p=0.2; 42% female, p=0.07) underwent AVR. Survey response rates were 96% at 1 yr and 57% at 3 yrs. Emotional well-being improved significantly in both groups post-op (AVS MC 4.12 [1.09, 7.14]; AVR MC 5.31 [1.38, 9.24]). Vitality was similar in AVS (MC 4.39 [1.41, 7.36] and AVR pt (MC 1.66 [-2.20, 5.52]. Physical functioning clinically decreased after AVS (MC -1.69 [-5.23, 1.85]) and remained the same after AVR (MC 0.85 [-3.76, 5.45]). However, all pt felt less limited by their physical health (AVS MC 2.91 [-1.19, 7.01]; AVR MC 3.34 [-1.99, 8.66]). Mental Component Summary score was 45.5±14.3 for AVS pt pre-op, and improved to 52.2±11.3 in follow-up. Mental Component Summary score was 47.8.±14.9 for AVS pt pre-op, and improved to 52.7±8.0 in follow-up. Physical Composite Summary scores were 44.4±14.0 for AVS pt and 43.5±12.0 for AVR pt at baseline and decreased at follow-up (AVS, 42.2±13.9; AVR, 42.3±11.1).
Pt with MFS report similar QOL after AVS or AVR. Postoperatively, emotional health improved while physical health declined, albeit not significantly.
Poster Hall, Hall A/B
Saturday, March 10, 2018, 10:00 a.m.-10:45 a.m.
Session Title: All Things Aortic!
Abstract Category: 09. Congenital Heart Disease: Adult
Presentation Number: 1123-358
- 2018 American College of Cardiology Foundation