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Health related quality of life after mitral valve repairs and replacements

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Abstract

Background: The decision to replace or repair mitral valves is often a difficult decision, and outcomes from the patients’ perspective should guide decision-making. We investigated whether the change in health related quality of life (HRQOL) after mitral valve surgery is different after valve repairs compared with replacements.Methods: We prospectively studied 25 patients with mitral valve replacement and 45 patients with valve repairs performed in 1998–99. We measured HRQOL at baseline and at 18 months using the Medical Outcomes Trust Short Form 36-item Health Survey (SF-36) questionnaire. We compared mean HRQOL scores of the groups with age-adjusted U.S. population scores. We used analysis of covariance to determine a change in HRQOL within groups (repair or replacement) and if the change in HRQOL was different between the groups.Results: We found few differences between the groups, with more men and simultaneous coronary artery bypass graft surgery in the valve repair group and more prior operation in the valve replacement group. HRQOL improved after surgery in most domains, and was comparable to age-adjusted U.S. norms in the valve repair group. In the multivariable analysis, mitral valve repair recipients reported higher social functioning compared with patients who received valve replacement (p = 0.04). We did not find other statistically significant differences. However, the adjusted improvements in the component scales of physical functioning (PCS) and mental functioning (MCS) were substantial in the valve repair group (mean changes: PCS = 6.8, p = 0.003; MCS = 8.1, p = 0.014) and less pronounced in the replacement group (mean changes: PCS = 3.6, p = 0.09; MCS = 4.3, fsp = 0.16).Conclusions: While many considerations influence the decision to repair or replace mitral valves, these findings suggest that repair may be better from the health status perspective. Further studies are necessary to validate this finding.

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Authors and Affiliations

  1. Center for Outcomes and Evidence, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD, 20850, USA

    Artyom Sedrakyan

  2. London School of Hygiene and Tropical Medicine, London, United Kingdom

    Artyom Sedrakyan

  3. Department of Surgery, Section of Cardiothoracic Surgery, Yale University School of Medicine, New Haven, CT, USA

    Artyom Sedrakyan & John A. Elefteriades

  4. Department of Medicine, and Rollins School of Public Health, Emory University School of Medicine, Atlanta, GA, USA

    Viola Vaccarino

  5. Center for Outcomes Research and Evaluation, Yale-New Haven Health, New Haven, CT, USA

    Jennifer A. Mattera, Zhenqiu Lin, Sarah A. Roumanis & Harlan M. Krumholz

  6. Department of Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT, USA

    Harlan M. Krumholz

  7. Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT, USA

    Harlan M. Krumholz

  8. Department of Medicine, Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, New Haven, CT, USA

    Harlan M. Krumholz

Authors
  1. Artyom Sedrakyan
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  2. Viola Vaccarino
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  3. John A. Elefteriades
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  4. Jennifer A. Mattera
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  5. Zhenqiu Lin
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  6. Sarah A. Roumanis
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  7. Harlan M. Krumholz
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Correspondence to Artyom Sedrakyan.

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Sedrakyan, A., Vaccarino, V., Elefteriades, J.A. et al. Health related quality of life after mitral valve repairs and replacements. Qual Life Res 15, 1153–1160 (2006). https://doi.org/10.1007/s11136-006-0055-3

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  • DOI: https://doi.org/10.1007/s11136-006-0055-3

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