RESUMO
Fundamento y objetivo: El objetivo de este estudio es el de comparar la calidad de vida de pacientes ancianos a los que se les ha realizado cirugía de recambio valvular aórtico (RVA) con la de la población general española de la misma edad y del mismo sexo. Pacientes: Se analizó un total de 163 pacientes con una edad igual o superior a 75 años que habían recibido RVA. La calidad de vida se evaluó con el test SF-12 (Short Form Health Survey 12). La mediana del período de seguimiento fue de 37,4 meses. El seguimiento se completó en un 95,6% de los pacientes supervivientes. Los resultados se compararon con los datos publicados para la población general española de la misma edad y del mismo sexo (n=1.312). Resultados: La mortalidad hospitalaria fue del 7,4%. El resultado medio de los componentes sumarios físico y mental fue para las mujeres de 44,69 y de 49,88, y para los varones de 47,38 y de 56,19, respectivamente. Al confrontarlos con la población general española, los pacientes intervenidos mostraron un estado de salud comparable. Conclusiones: Los pacientes ancianos candidatos a RVA representan un grupo de alto riesgo quirúrgico. Sin embargo, la calidad de vida postoperatoria es comparable a la de la población general de la misma edad y del mismo sexo (AU)
Background and objective: The aim of the study was to compare the quality of life of elderly patients undergoing aortic valve replacement with that of a reference group. Patients: A total of 163 patients aged ⩾75 years who underwent aortic valve replacement were analyzed. Quality of life was evaluated by the Short Form Health Survey test 12 (SF-12). The median follow-up period was 37.4 months. Quality of life follow-up was complete at 95.6% of mid-term survivors. Quality of life data was compared with published data of a sample of the Spanish population (n.1312) of the same age and same sex .Results: Overall 30-day mortality was 7.4%. The mean SF-12 physical component score and SF-12 mental component score of the study population were 44,69 and 49,88 for woman and 47,38 and 56,19 for men, respectively. Results: Our sample population showed a post operative quality of live comparable with that of the general population. Conclusions: Elderly patients who are candidates to aortic valve replacement represent a high risk population. Nevertheless, the quality of life achieved post-operatively is comparable with that of the general population (AU)
Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , /métodos , Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Artéria Femoral , CateterismoRESUMO
BACKGROUND AND OBJECTIVE: In recent years, techniques for implantation of aortic prosthesis via catheter have been developed as a therapeutic alternative in patients with severe aortic stenosis rejected for surgery. The correct selection of candidates is one of the more complex aspects of this treatment. We analyzed the acceptance rate in our environment for transcatheter aortic valve implantation in patients referred to our hospital for evaluation as possible candidates, describing the exclusion reasons. PATIENTS AND METHOD: 30 patients with severe aortic stenosis and rejected for surgical aortic valve replacement were referred to our hospital to evaluate transcatheter aortic valve implantation. The patients first underwent clinical evaluation and were studied with echocardiography, angiography and computed tomography. RESULTS: Of the 30 patients, 18 were rejected for the procedure (60%): 4 patients with non-severe aortic stenosis, 2 asymptomatic patients, 2 patients who finally underwent surgery because of a low-surgical-risk, 5 patients with contraindications for the procedure, 2 patients who finally did not want to undergo the procedure and 3 patients were further rejected because the vascular access was inappropriate. Of the remaining 12 patients initially accepted, 3 died before the procedure was performed. Finally, only 9 patients (30%) underwent transcatheter aortic valve implantation. CONCLUSIONS: Of the patients referred for transcatheter aortic valve implantation, only 40% were accepted. The mortality rate during the evaluation process of this procedure is high, showing that these patients are terminally ill.
