Quality of life after transcatheter or surgical aortic valve replacement using the Toronto Aortic Stenosis Quality of Life Questionnaire

Simon Kennon, Rima Styra, Nikolaos Bonaros, Lukas Stastny, Mauro Romano, Thierry Lefèvre, Carlo Di Mario, Pierluigi Stefàno, Flavio Luciano Ribichini, Dominique Himbert, Marina Urena-Alcazar, Jorge Salgado-Fernandez, Jose Joaquin Cuenca Castillo, Bruno Garcia, Cornelia Deutsch, Lenka Sykorova, Jana Kurucova, Martin Thoenes, Claudia Lüske, Peter Bramlage, Derk Frank, Simon Kennon, Rima Styra, Nikolaos Bonaros, Lukas Stastny, Mauro Romano, Thierry Lefèvre, Carlo Di Mario, Pierluigi Stefàno, Flavio Luciano Ribichini, Dominique Himbert, Marina Urena-Alcazar, Jorge Salgado-Fernandez, Jose Joaquin Cuenca Castillo, Bruno Garcia, Cornelia Deutsch, Lenka Sykorova, Jana Kurucova, Martin Thoenes, Claudia Lüske, Peter Bramlage, Derk Frank

Abstract

Background: The Toronto Aortic Stenosis Quality of Life Questionnaire (TASQ) is a validated instrument for assessing quality of life (QoL) in patients with severe aortic stenosis (AS). In this study, we evaluated health status outcomes, based on the TASQ, in patients with severe AS undergoing transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR).

Methods: The TASQ registry was a prospective observational registry. Patients with severe AS from nine centres in Europe and one in Canada underwent either SAVR or transfemoral TAVR. Patients completed the TASQ, Kansas City Cardiomyopathy Questionnaire and Short Form-12 V.2 prior to the intervention, predischarge, and at 30-day and 3-month follow-ups. Primary end point was the TASQ score.

Results: In both the TAVR (n=137) and SAVR (n=137) cohorts, significant increases were observed in all three scores. The overall TASQ score improved as did all but one of the individual domains at 3 months after the intervention (p<0.001). TASQ health expectations were the only domain which worsened (p<0.001). Across TASQ subscores, significant changes were evident from the time of discharge in the TAVR and 30-day follow-up in the SAVR cohort. In a categorical analysis of the TASQ, 39.7% of the TAVR group and 35.0% of the SAVR group had a substantially improved health status at 3 months compared with baseline.

Conclusions: The TASQ captured changes in QoL among patients with severe AS who were treated with TAVR or SAVR. QoL improved substantially after either intervention, as indicated by changes in the TASQ overall score at 3 months.

Trial registration number: NCT03186339.

Keywords: aortic diseases; aortic valve stenosis; healthcare; heart valve prosthesis implantation; outcome assessment; quality of healthcare.

Conflict of interest statement

Competing interests: PB is the representative of the Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany. LS, JK and MT are employees of the funder. All centres were paid by IPPMed for the enrolment and documentation of patients.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Absolute TASQ score at baseline and 3-month follow-up. Bars between columns represent the maximum achievable score per domain. SAVR, surgical aortic valve replacement; TASQ, Toronto Aortic Stenosis Quality of Life Questionnaire; TAVR, transcatheter aortic valve replacement.
Figure 2
Figure 2
TAVR vs SAVR at baseline, discharge, 30 days and 3 months after the intervention, adjusted for differences in baseline TASQ score. SAVR, surgical aortic valve replacement; TASQ, Toronto Aortic Stenosis Quality of Life Questionnaire; TAVR, transcatheter aortic valve replacement. *P

Figure 3

Proportion of patients who underwent…

Figure 3

Proportion of patients who underwent TAVR and SAVR achieving specific levels of clinically…

Figure 3
Proportion of patients who underwent TAVR and SAVR achieving specific levels of clinically relevant change in health status (TASQ score and survival status). P values are derived from the Mann-Whitney U test for these categorical analyses, ordinal categories for clinically relevant changes in the TASQ (plus survival status) were defined as death, worse (decrease of >5% vs baseline), no change (change of between –5% and
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Figure 3
Figure 3
Proportion of patients who underwent TAVR and SAVR achieving specific levels of clinically relevant change in health status (TASQ score and survival status). P values are derived from the Mann-Whitney U test for these categorical analyses, ordinal categories for clinically relevant changes in the TASQ (plus survival status) were defined as death, worse (decrease of >5% vs baseline), no change (change of between –5% and

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