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Beyond Adding Years to Life: Health-related Quality-of-life and Functional Outcomes in Patients with Severe Aortic Valve Stenosis at High Surgical Risk Undergoing Transcatheter Aortic Valve Replacement
Aortic valve stenosis (AVS) is the most frequent acquired valvular heart disease in western industrialized countries and its prevalence considerably increases with age. Once becoming symptomatic severe AVS has a very poor prognosis. Progressive and rapid symptom deterioration leads to an impairment...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Bentham Science Publishers
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941091/ https://www.ncbi.nlm.nih.gov/pubmed/24313648 http://dx.doi.org/10.2174/1573403X09666131202121750 |
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author | Deutsch, Marcus-André Bleiziffer, Sabine Elhmidi, Yacine Piazza, Nicolo Voss, Bernhard Lange, Ruediger Krane, Markus |
author_facet | Deutsch, Marcus-André Bleiziffer, Sabine Elhmidi, Yacine Piazza, Nicolo Voss, Bernhard Lange, Ruediger Krane, Markus |
author_sort | Deutsch, Marcus-André |
collection | PubMed |
description | Aortic valve stenosis (AVS) is the most frequent acquired valvular heart disease in western industrialized countries and its prevalence considerably increases with age. Once becoming symptomatic severe AVS has a very poor prognosis. Progressive and rapid symptom deterioration leads to an impairment of functional status and compromised healthrelated quality-of-life (HrQoL) simultaneously. Until recently, surgical aortic valve replacement (SAVR) has been the only effective treatment option for improving symptoms and prolonging survival. Transcatheter aortic valve replacement (TAVR) emerged as an alternative treatment modality for those patients with severe symptomatic AVS in whom the risk for SAVR is considered prohibitive or too high. TAVR has gained clinical acceptance with almost startling rapidity and has even quickly become the standard of care for the treatment of appropriately selected individuals with inoperable AVS during recent years. Typically, patients currently referred for and treated by TAVR are elderly with a concomitant variable spectrum of multiple comorbidities, disabilities and limited life expectancy. Beyond mortality and morbidity, the assessment of HrQoL is of paramount importance not only to guide patient-centered clinical decision-making but also to judge this new treatment modality. As per current evidence, TAVR significantly improves HrQoL in high-surgical risk patients with severe AVS with sustained effects up to two years when compared with optimal medical care and demonstrates comparable benefits relative to SAVR. Along with a provision of a detailed overview of the current literature regarding functional and HrQoL outcomes in patients undergoing TAVR, this review article addresses specific considerations of the HrQoL aspect in the elderly patient and finally outlines the implications of HrQoL outcomes for medico-economic deliberations. |
format | Online Article Text |
id | pubmed-3941091 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Bentham Science Publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-39410912014-11-01 Beyond Adding Years to Life: Health-related Quality-of-life and Functional Outcomes in Patients with Severe Aortic Valve Stenosis at High Surgical Risk Undergoing Transcatheter Aortic Valve Replacement Deutsch, Marcus-André Bleiziffer, Sabine Elhmidi, Yacine Piazza, Nicolo Voss, Bernhard Lange, Ruediger Krane, Markus Curr Cardiol Rev Article Aortic valve stenosis (AVS) is the most frequent acquired valvular heart disease in western industrialized countries and its prevalence considerably increases with age. Once becoming symptomatic severe AVS has a very poor prognosis. Progressive and rapid symptom deterioration leads to an impairment of functional status and compromised healthrelated quality-of-life (HrQoL) simultaneously. Until recently, surgical aortic valve replacement (SAVR) has been the only effective treatment option for improving symptoms and prolonging survival. Transcatheter aortic valve replacement (TAVR) emerged as an alternative treatment modality for those patients with severe symptomatic AVS in whom the risk for SAVR is considered prohibitive or too high. TAVR has gained clinical acceptance with almost startling rapidity and has even quickly become the standard of care for the treatment of appropriately selected individuals with inoperable AVS during recent years. Typically, patients currently referred for and treated by TAVR are elderly with a concomitant variable spectrum of multiple comorbidities, disabilities and limited life expectancy. Beyond mortality and morbidity, the assessment of HrQoL is of paramount importance not only to guide patient-centered clinical decision-making but also to judge this new treatment modality. As per current evidence, TAVR significantly improves HrQoL in high-surgical risk patients with severe AVS with sustained effects up to two years when compared with optimal medical care and demonstrates comparable benefits relative to SAVR. Along with a provision of a detailed overview of the current literature regarding functional and HrQoL outcomes in patients undergoing TAVR, this review article addresses specific considerations of the HrQoL aspect in the elderly patient and finally outlines the implications of HrQoL outcomes for medico-economic deliberations. Bentham Science Publishers 2013-11 2013-11 /pmc/articles/PMC3941091/ /pubmed/24313648 http://dx.doi.org/10.2174/1573403X09666131202121750 Text en © 2013 Bentham Science Publishers http://creativecommons.org/licenses/by/2.5/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/), which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Article Deutsch, Marcus-André Bleiziffer, Sabine Elhmidi, Yacine Piazza, Nicolo Voss, Bernhard Lange, Ruediger Krane, Markus Beyond Adding Years to Life: Health-related Quality-of-life and Functional Outcomes in Patients with Severe Aortic Valve Stenosis at High Surgical Risk Undergoing Transcatheter Aortic Valve Replacement |
title | Beyond Adding Years to Life: Health-related Quality-of-life and
Functional Outcomes in Patients with Severe Aortic Valve Stenosis at High
Surgical Risk Undergoing Transcatheter Aortic Valve Replacement |
title_full | Beyond Adding Years to Life: Health-related Quality-of-life and
Functional Outcomes in Patients with Severe Aortic Valve Stenosis at High
Surgical Risk Undergoing Transcatheter Aortic Valve Replacement |
title_fullStr | Beyond Adding Years to Life: Health-related Quality-of-life and
Functional Outcomes in Patients with Severe Aortic Valve Stenosis at High
Surgical Risk Undergoing Transcatheter Aortic Valve Replacement |
title_full_unstemmed | Beyond Adding Years to Life: Health-related Quality-of-life and
Functional Outcomes in Patients with Severe Aortic Valve Stenosis at High
Surgical Risk Undergoing Transcatheter Aortic Valve Replacement |
title_short | Beyond Adding Years to Life: Health-related Quality-of-life and
Functional Outcomes in Patients with Severe Aortic Valve Stenosis at High
Surgical Risk Undergoing Transcatheter Aortic Valve Replacement |
title_sort | beyond adding years to life: health-related quality-of-life and
functional outcomes in patients with severe aortic valve stenosis at high
surgical risk undergoing transcatheter aortic valve replacement |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941091/ https://www.ncbi.nlm.nih.gov/pubmed/24313648 http://dx.doi.org/10.2174/1573403X09666131202121750 |
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