摘要
Objectives We sought to determine whether changes in quality of life at 18 mon ths following aortic valve replacement differ depending on the use of tissue val ves or mechanical valves. Methods We prospectively studied 73 patients with tiss ue valve replacements and 53 patients with mechanical valve replacements perform ed from April 1998 through March 1999 at Yale-New Haven Hospital. Quality of li fe was measured at baseline and at 18 months using the Medical Outcomes Trust Sh ort Form 36-Item Health Survey. Results Baseline unadjusted mean quality-of-l ife scores were lower in tissue valve recipients than in mechanical valve recipi ents and, for both groups, were generally lower than US population norms. At 18 months postoperatively, quality-of-life scores were greatly improved in both g roups and were comparable to population norms (ie, within one-half a standard d eviation). After adjusting for baseline quality of life, age, and other prognost ic factors in an analysis of covariance, improvements in quality-of-life score s for tissue valve recipients versus mechanical valve recipients were similar. O f 10(8 domains and 2 summary) scales examined, the only significant difference b etween the 2 groups was for the improvement in role limitations due to physical problems (Role Physical), which was more favorable in patients with mechanical v alve implants (P=.04). Conclusions The use of tissue valve implants versus mecha nical valve implants has little influence on improvement in quality of life at 1 8 months following aortic valve replacement. Thus, decisions about whether to ch oose a tissue valve or mechanical valve implant should depend upon other factors such as rates of complications and differences in the life span of the implants .
Objectives We sought to determine whether changes in quality of life at 18 mon ths following aortic valve replacement differ depending on the use of tissue val ves or mechanical valves. Methods We prospectively studied 73 patients with tiss ue valve replacements and 53 patients with mechanical valve replacements perform ed from April 1998 through March 1999 at Yale-New Haven Hospital. Quality of li fe was measured at baseline and at 18 months using the Medical Outcomes Trust Sh ort Form 36-Item Health Survey. Results Baseline unadjusted mean quality-of-l ife scores were lower in tissue valve recipients than in mechanical valve recipi ents and, for both groups, were generally lower than US population norms. At 18 months postoperatively, quality-of-life scores were greatly improved in both g roups and were comparable to population norms (ie, within one-half a standard d eviation). After adjusting for baseline quality of life, age, and other prognost ic factors in an analysis of covariance, improvements in quality-of-life score s for tissue valve recipients versus mechanical valve recipients were similar. O f 10(8 domains and 2 summary) scales examined, the only significant difference b etween the 2 groups was for the improvement in role limitations due to physical problems (Role Physical), which was more favorable in patients with mechanical v alve implants (P=.04). Conclusions The use of tissue valve implants versus mecha nical valve implants has little influence on improvement in quality of life at 1 8 months following aortic valve replacement. Thus, decisions about whether to ch oose a tissue valve or mechanical valve implant should depend upon other factors such as rates of complications and differences in the life span of the implants .
