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

Semin Thorac Cardiovasc Surg. 2019 Autumn;31(3):549-558. doi: 10.1053/j.semtcvs.2019.02.002. Epub 2019 Feb 5.

Abstract

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.

Keywords: Congenital heart disease; Quality of life; Rand-36.

Publication types

  • Multicenter Study
  • Observational Study
  • Video-Audio Media

MeSH terms

  • Adult
  • Aged
  • 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*
  • Recovery of Function
  • Retrospective Studies
  • Risk Factors
  • Social Behavior
  • Treatment Outcome
  • Ventricular Function
  • Young Adult