Quality of Life Among Patients With Congenital Heart Disease After Valve Replacement

• Published in: Seminars in thoracic and cardiovascular surgery Vol. 31; no. 3; pp. 549 - 558
• Main Authors: Pragt, Hanna, MS, Pieper, Petronella G., PhD, van Slooten, Ymkje J., PhD, Freling, Hendrik G., PhD, van Dijk, Arie P.J., PhD, Sieswerda, Gertjan T.J., PhD, Bouma, Berto J., PhD, Post, Marco C., PhD, Jongbloed, Monique R.M., PhD, Willems, Tineke P., PhD, Ebels, Tjark, PhD, van Melle, Joost P., PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2019
• Subjects: Adult; Aged; Cardiothoracic Surgery; Congenital heart disease; Cross-Sectional Studies; Exercise Tolerance; Female; Health Status; Heart Defects, Congenital - diagnosis; Heart Defects, Congenital - physiopathology; Heart Defects, Congenital - psychology; Heart Defects, Congenital - surgery; Heart Valve Prosthesis Implantation - adverse effects; Heart Valves - physiopathology; Heart Valves - surgery; Hemodynamics; Humans; Life Expectancy; Male; Middle Aged; Netherlands; Quality of Life; Rand-36; Recovery of Function; Retrospective Studies; Risk Factors; Social Behavior; Treatment Outcome; Ventricular Function; Young Adult; Netherlands; aortic valve replacement; tricuspid valve replacement; prostheses in adult congenital heart valve disease; LVEF; MVR; maximum oxygen capacity; Congenital heart disease; atrial septum defect; pulmonary valve replacement; PVR; left ventricular ejection fraction; Dutch congenital corvitia; BSA; TVR; ASD; electrocardiogram; CONCOR; PROSTAVA; percentage of predicted exercise capacity; predicted maximum oxygen; W peak; W pred; ECG; CMR; Rand-36; health-related quality of life; TAPSE; VO 2peak; predicted workload; VO 2pred; Quality of life; QOL; tricuspid annular plane systolic excursion; HRQOL; maximum workload; PPEC; AVR; cardiac magnetic resonance; mitral valve replacement; CHD; body surface area; VO2pred; VO2peak; Wpred; Wpeak
• DOI: 10.1053/j.semtcvs.2019.02.002
• ISSN: 1043-0679

Most studies concerning valve replacement in congenital heart disease (CHD) focus on surgical morbidity and mortality. However, with the increased life expectancy of these patients, the focus shifts to quality of life (QOL). The aim of this study was to report and compare the QOL of CHD patients after valve replacement with the general population and to find factors associated with QOL. In a multicenter cross-sectional observational study of adults with CHD, QOL was measured with the RAND-36 questionnaire (a health-related QOL questionnaire, with 8 domains scoring from 0 to 100; higher scores indicate a better QOL). Functional status was measured with exercise capacity testing. Uni- and multivariable linear regression was used to find associations with QOL. In total, 324 patients with CHD and a prosthetic valve were included in this study. CHD patients with a valve replacement scored significantly lower than the general population on the general health, vitality, and social functioning domains ( P < 0.05). On the bodily pain domain, they scored significantly higher (less pain) ( P < 0.001). Higher NYHA class was associated with a lower QOL for all domains, reflecting the importance of functional capacity. Other variables related to aspects of QOL were age, gender, exercise capacity, and employment status. Adult patients with CHD and a prosthetic valve have lower scores on the QOL domains general health, vitality, and social functioning as compared to the general population. NYHA class was negatively associated with all QOL domains. Health care professionals should be aware of these patterns in counseling patients.