Publication: Impacto de la implantación de la válvula aórtica percutánea en la calidad de vida, nivel de independencia y demanda de apoyo socio-familiar, en pacientes ancianos con estenosis aórtica severa
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2015-11-19
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Universidad Complutense de Madrid
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Abstract
La estenosis aórtica severa (EAS) es la patología valvular más frecuente dentro de la población añosa, siendo la sustitución valvular quirúrgica el único tratamiento eficaz.La edad avanzada, se asocia con mayor frecuencia a comorbilidades, que contribuyen al aumento del riesgo operatorio y no existe ningún tratamiento médico efectivo para la EAS. Gracias a los avances de la cardiología intervencionista se presenta una alternativa: La implantación de prótesis valvular aortica por vía percutánea o transapical (TAVI).Los objetivos del presente estudio son: Conocer el impacto de TAVI en pacientes ancianos con estenosis aortica severa en aspectos como la capacidad funcional, la calidad de vida, el nivel de dependencia y la demanda de apoyo socio-familiar a los 6 meses del implante y su seguimiento a lo largo del tiempo (1 mes, 3 y 6 meses), así como evaluar el impacto según la situación basal de calidad de vida y nivel de dependencia y el comportamiento de la población por subgrupos de edad.A partir de los resultados obtenidos se concluye:A los seis meses del implante de TAVI los pacientes mejoran significativamente su capacidad funcional, en la calidad de vida, así como en nivel de dependencia para actividades básicas e instrumentales de la vida diaria (ABVD, AIVD).Analizando la evolución en el tiempo tras el implante de TAVI, los pacientes mejoran su capacidad funcional de forma más significativa al mes después de la intervención. La Calidad de Vida y el nivel de dependencia para ABVD y AIVD mejoran desde el primer al tercer mes tras el implante y los requerimientos de apoyo socio-familiar se incrementan durante el primer mes tras el implante así como los ingresos hospitalarios. Según su situación basal los pacientes que físicamente se encuentran peor mejoran significativamente antes y con mayor impacto.La edad no es un factor predictor, los pacientes pueden beneficiarse o no, independientemente de la edad. Palabras CLAVE: Remplazo de la Válvula Aórtica Transcatéter. Anciano. Calidad de vida
Percutaneous aortic valve implantation in the elderly with severe aortic stenosis: Impact on quality of life, dependency level and social and family support demands.Severe aortic stenosis (SAS) is the most common vale disease in the elderly and surgical valve replacement is the only accepted treatment.However, advanced age is frequently associated with multiple co-morbidities that increase peri-operative risk, and survival rates with medical treatment alone are poor. Fortunately, technological developments achieved in interventional cardiology have facilitated the onset of an alternative treatment:trans-catheter aortic valve replacement (TAVR).Objectives of the present study are: Determine TAVR impact on patients with SAS, especially on areas such as functional capacity, quality of life, level of dependency and social and family support demands both at 6 months post-procedure and during the whole follow-up (at one month, three months and six months follow-up). We also wished to evaluate TAVR repercussion on those areas among different age groups and according to baseline quality of life and level of dependency.Results show that at 6 months patients improve their functional capacity, quality of life and level of dependency for basic personal daily activities.Patients improve predominantly during the first month after the intervention. Quality of life and level of dependency for both basic personal and instrumental activities get better from the first month to the third month after valve implantation, while hospital admissions, social and family demands increase after the first month is completed.According to patients baseline situation, those who are at a worse situation improve earlier and to a greater extent.Age does not predict accurately TAVR benefit, and patients may improve or not regardless of their age. Key words:Trans-catheter aortic valve replacement. Elderly. Quality of life
Percutaneous aortic valve implantation in the elderly with severe aortic stenosis: Impact on quality of life, dependency level and social and family support demands.Severe aortic stenosis (SAS) is the most common vale disease in the elderly and surgical valve replacement is the only accepted treatment.However, advanced age is frequently associated with multiple co-morbidities that increase peri-operative risk, and survival rates with medical treatment alone are poor. Fortunately, technological developments achieved in interventional cardiology have facilitated the onset of an alternative treatment:trans-catheter aortic valve replacement (TAVR).Objectives of the present study are: Determine TAVR impact on patients with SAS, especially on areas such as functional capacity, quality of life, level of dependency and social and family support demands both at 6 months post-procedure and during the whole follow-up (at one month, three months and six months follow-up). We also wished to evaluate TAVR repercussion on those areas among different age groups and according to baseline quality of life and level of dependency.Results show that at 6 months patients improve their functional capacity, quality of life and level of dependency for basic personal daily activities.Patients improve predominantly during the first month after the intervention. Quality of life and level of dependency for both basic personal and instrumental activities get better from the first month to the third month after valve implantation, while hospital admissions, social and family demands increase after the first month is completed.According to patients baseline situation, those who are at a worse situation improve earlier and to a greater extent.Age does not predict accurately TAVR benefit, and patients may improve or not regardless of their age. Key words:Trans-catheter aortic valve replacement. Elderly. Quality of life
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Enfermería, Fisioterapia y Podología, leída el 20-07-2015