Improvement in Quality of Life in Old People with Aortic Stenosis after Transcatheter Aortic Valve Implantation

Background: This study aimed to compare the improvement in the quality of life (QoL) in the long-term follow-up of 12 to 24 months after transcatheter aortic valve implantation (TAVI) therapy for old people with severe aortic stenosis. Methods: According to the guidelines provided by PRISMA, published studies till 15 June, 2014 were retrieved from Google Scholar, Pubmed, Embase and CNKI. Health-related QoL was evaluated at beginning and at 12 to 24 months with five kinds of instruments. Funnel plots were used to test the potential publication bias, and analyze the source of heterogeneity, such as meta-regression, subgroup and sensitivity. Results: Our meta-analysis involved ten studies with 1359 patients. Preprocedural summary 12-item Short Form (SF-12) physical and mental scores showed a significant improvement after one year after TAVI [weighted mean difference (WMD): -10.61, 95% confidence interval (CI): -15.06, -6.15; WMD: -6.39, 95%CI: -9.08, -3.70; respectively]. One year follow-up visit after TAVI revealed significantly improved QoL compared to baseline in Kansas City Cardiomyopathy Questionnaire (KCCQ) and EuroQol (EQ-5D) (WMD: -29.44, 95%CI: -33.29, -26.58; WMD: -0.09, 95%CI: -0.12, -0.06; respectively). At 12 to 24 months, weighted mean 36-item Short-Form (SF-36) physical improved by 16.96 points (95%CI: -27.77, -6.16) and SF-36-mental improved by 5.57 points (95%CI: -9.96, -1.19); weighted mean Minnesota Living with Heart Failure Questionnaire (MLHFQ) decreased by 22.29 points (95%CI: 16.09, 28.48). Conclusion: This technique provides a promising therapy approach for old patients with severe symptomatic aortic stenosis in high-risk surgery, and there are significant improvements for this group in health-related quality of life in the follow-up.