Evaluation of the quality of life after surgical correctionof valvular heart diseases and heart rhythm disorders

Authors: Meladze M.G., Dzhandzhagava D.A., Marganiya G.T.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery of Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2019-13-4-339-348

For citation: Meladze M.G., Dzhandzhagava D.A., Marganiya G.T. Evaluation of the quality of life after surgical correction of valvular heart diseases and heart rhythm disorders. Creative Cardiology. 2019; 13 (4): 339–48 (in Russ.). DOI: 10.24022/ 1997-3187-2019-13-4-339-348

Received / Accepted:  10.12.2019/16.12.2019

Keywords: acquired heart disease heart arrhythmia maze procedure radiofrequency ablation cryoablation

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Abstract

Objective. To study the quality of life of patients in the long term after surgical correction of valvular heart diseases (VHD) and heart rhythm disorders (HRD).

Material and methods. 117 patients were examined in an average of 5.3±1.9 years after surgical correction of VHD and HRD. Quantitative data are presented as the median and interquartile range – Me [25; 75%]. Age at the time of the survey ranged from 38 to 78 years (49 [45; 59%]). 67 (57.2%) patients had a permanent atrial fibrillation (AF). Patients were divided into 2 groups: in the first group, along with the correction of valvular pathology, cryo-, laser and electric destruction of the AV node with pacemaker implantation, Seeley operation, electrical isolation of the left atrium, cryodestruction of the coronary sinus (n=40) were performed. In the second – valvular correction and operation Labyrinth (n=77) were performed. Before and after the operation, a short form of the SF-36 questionnaire was used.

Results. In both groups, after surgery, a statistically significant improvement was obtained compared to preoperative data on the scales of physical functioning (p<0.01), pain intensity (p<0.001), general health (p<0.001), vital activity (p<0.001), mental health component (p<0.01). Differences in the overall indicator of the physical component of health compared to preoperative were obtained only in the group of patients after the operation Labyrinth (p=0.041). It was found that in the general group of patients, lower values on the scale of physical functioning were available in older patients (R=–0.31, p=0.005), with a large number of operations (R=–0.31, p=0.006), a large volume of left atrium before surgery (R=–0.39, p=0.04), the presence of pacemaker or persistent AF after surgery (p<0.001), as well as concomitant hypertension (p<0.01).

Conclusion. After surgery, there is an improvement in both physical functioning and mental health, quality of life indicators are comparable to those of the population as a whole. Improvement on the scale of “Role functioning due to physical condition” and the overall indicator of the physical component of health compared with preoperative obtained only after maze procedure.

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About Authors

  • Mayya G. Meladze, Junior Researcher, ORCID
  • Daredzhan A. Dzhandzhgava, Senior Researcher, ORCID
  • Guram T. Marganiya, Resident Physician

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery