Quality of life in older adults with aortic stenosis

a narrative review

Judith Horrocks, José Closs, Felicity Astin

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Aortic stenosis in older adults can lead to symptoms of breathlessness, dizziness, syncope and angina. While surgical AVR is the optimum treatment, it is not suitable for frail older people who may have other significant comorbidities. TAVI provides a safer alternative. There is evidence that aortic valve replacement reduces mortality and morbidity, but less is known about its effect on quality of life (QoL) in older adults. Aims and objectives: To carry out a narrative review of the existing literature on quality of life (QoL) after surgical aortic valve replacement (AVR) or transcatheter aortic valve replacement (TAVI) with the aim of identifying what is known about QoL pre- and postvalve replacement. Conclusions: There is some evidence that QoL improves after aortic valve replacement, but there are significant gaps in our knowledge. There are no studies that compare QoL after TAVI vs. surgical AVR; thus, we do not know the relative effect of the different procedures on QoL. The literature does not adequately explore why some people have improved QoL after aortic valve replacement and others do not. There appears to be some evidence that the existence of comorbidities may negatively influence QoL after valve replacement, but there is not enough consistent data on comorbidities to explore this further. Study designs are heterogeneous and prevent any meta-analysis of findings. Implications for practice: Decision-making processes regarding the suitability of patients for aortic valve replacement should include an assessment of the potential effects on overall QoL, rather than just relief of cardiac-related symptoms. Consideration of patients' social, emotional and physical needs both before and after valve replacement is essential if health services are serious about improving QoL as well as mortality and morbidity.

Original languageEnglish
Pages (from-to)227-246
Number of pages20
JournalInternational journal of older people nursing
Volume9
Issue number3
Early online date11 Apr 2013
DOIs
Publication statusPublished - Sep 2014
Externally publishedYes

Fingerprint

Aortic Valve Stenosis
Quality of Life
Aortic Valve
Surgical Instruments
Comorbidity
Morbidity
Mortality
Syncope
Dizziness
Dyspnea
Health Services
Meta-Analysis
Decision Making

Cite this

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abstract = "Background: Aortic stenosis in older adults can lead to symptoms of breathlessness, dizziness, syncope and angina. While surgical AVR is the optimum treatment, it is not suitable for frail older people who may have other significant comorbidities. TAVI provides a safer alternative. There is evidence that aortic valve replacement reduces mortality and morbidity, but less is known about its effect on quality of life (QoL) in older adults. Aims and objectives: To carry out a narrative review of the existing literature on quality of life (QoL) after surgical aortic valve replacement (AVR) or transcatheter aortic valve replacement (TAVI) with the aim of identifying what is known about QoL pre- and postvalve replacement. Conclusions: There is some evidence that QoL improves after aortic valve replacement, but there are significant gaps in our knowledge. There are no studies that compare QoL after TAVI vs. surgical AVR; thus, we do not know the relative effect of the different procedures on QoL. The literature does not adequately explore why some people have improved QoL after aortic valve replacement and others do not. There appears to be some evidence that the existence of comorbidities may negatively influence QoL after valve replacement, but there is not enough consistent data on comorbidities to explore this further. Study designs are heterogeneous and prevent any meta-analysis of findings. Implications for practice: Decision-making processes regarding the suitability of patients for aortic valve replacement should include an assessment of the potential effects on overall QoL, rather than just relief of cardiac-related symptoms. Consideration of patients' social, emotional and physical needs both before and after valve replacement is essential if health services are serious about improving QoL as well as mortality and morbidity.",
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Quality of life in older adults with aortic stenosis : a narrative review. / Horrocks, Judith; Closs, José; Astin, Felicity.

In: International journal of older people nursing, Vol. 9, No. 3, 09.2014, p. 227-246.

Research output: Contribution to journalArticle

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