Harvard Heart Letter

Update: Quality of life after aortic valve replacement

Some older people with stiff, failing aortic valves (aortic stenosis) are too frail to withstand open-heart surgery to replace the valve. But a technique called transcatheter aortic valve replacement (TAVR) delivers the new valve to the heart through a catheter that's threaded into an artery in the groin and maneuvered into the heart. This less-invasive option leads to a far shorter recovery time but a slightly higher risk of stroke than the traditional surgery. As such, choosing the most appropriate candidates for TAVR remains a matter of debate.

Now, a review of more than 11,000 people who underwent TAVR provides more information about how people fare during the year or two after the procedure. Over all, the participants' symptoms (such as shortness of breath and fatigue) improved, as did their ability to do everyday tasks. But improvements in their emotional well-being and their general physical health were small and inconsistent. More research is needed to better identify those people who are most likely not only to survive but also to have a good quality of life after TAVR, the authors conclude. Their study appeared in Annals of Internal Medicine.

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