German Registry Shows TAVI Improves Quality of Life in Patients With Severe Aortic Stenosis  

August 28, 2012—The European Society of Cardiology (ESC) announced the presentation of the German transcatheter aortic valve implantation (TAVI) registry at the 2012 ESC congress in Munich, Germany, by Prof. Till Neumann, MD, of the University Hospital of Essen in Germany.

The ESC press release stated that the prospective multicenter registry includes patients with symptomatic, severe aortic stenosis since January 2009. Prof. Neumann commented, “The registry was designed to monitor current use and outcomes of transcatheter aortic valve interventions in daily clinical routine and to evaluate safety, effectiveness, and health economic data. Therefore, the registry gives insight into a real-world setting of using the TAVI procedure.”

The ESC noted that the German TAVI registry is driven by the scientific interest of the participating hospitals, financed by the Institut für Herzinfarktforschung in Ludwigshafen, Germany, and is completely independent from industry.

According to the ESC, the registry assessed health-related quality of life at baseline, 30 days, and 12 months with the EQ-5D questionnaire. The study used quality-of-life data for a total of 415 patients who survived 12 months after TAVI (average age, 81.9 ± 5.9 years; men, 37.3%). At 12 months, TAVI patients reported improvements with regard to each single dimension of the EQ-5D. In particular, the distribution of the three levels (no problems, some problems, extreme problems) changed with regard to usual activities and discomfort after 12 months.

For usual activities, the proportion of patients with no problems increased from 17.5% to 48.6%, patients with some problems decreased from 72.5% to 39.7%, and patients with extreme problems increased slightly from 10.1% to 11.7%. For discomfort, the proportion of patients with no problems increased from 22.7% to 61.9%, patients with some problems decreased from 69.1% to 33.3%, and patients with extreme problems decreased from 8.3% to 4.8%. Prof. Neumann noted, “Patients gain improvements in their usual activities and feel more comfortable.” 

In the ESC press release, Prof. Neumann commented, “One of the main findings of our study is a remarkable increase in patients' self-ratings of quality of life after TAVI.” As summarized in the ESC announcement, scores on the visual analogue health scale (EQ VAS), which records the patient's self-rated health on a vertical, visual analogue scale, significantly improved from a mean value of 44.7% ± 16.5% at baseline to 62.9% ± 17.4% at 30 days. However, even more important was the fact that this benefit in quality of life was sustained, as indicated by the patient's self-rated health status after 1 year (65.1% ± 20.6%).

Prof. Neumann concluded, “Our results demonstrate that the minimally invasive procedure of TAVI does not only save lives but also leads to a remarkable improvement in health-related quality of life in a real-world setting. This benefit in quality of life lasts for a long time period.” He added, “Patients with severe aortic stenosis can profit from TAVI—the gain in health-related quality of life confirms this. Our findings regarding quality of life could give further impetus to the argument for performing TAVI in older patients with severe aortic stenosis.”