Friday, 18. of April 2014
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What quality of life can I expect after heart valve replacement?

The question of quality of life has not yet been answered
A review of the world wide literature shows that questions about the quality of life after mechanical heart valve replacement have so far remained unanswered. Up to now scientific interest has been focussed only on survival statistics and complication rates.

Therefore, the ESCAT study for the first time used special assessment methods to examine quality of life as an increasingly important quality feature and determine how patients respond after mechanical heart valve replacement and how they are accepted by their environment.

The patients were asked about their quality of life after the operation. The assessment was based on questionnaires used in the United States and adapted for use in Germany.

How can quality of life be measured?
In Western thinking, quality of life is not open to direct observation. Nevertheless, we believe that the following four points describe quality of life and also allow it to be measured:

  •  psychological well-being (e.g. anxiety, depression, behavioural disturbances);
  •  functioning and performance in various areas of daily life (e.g. work, family, leisure);
  • social well-being (e.g. couple relationships, social contact);
  •  physical status (e.g. state of health, complaints).

Scores were given for the following areas: "physical functioning" (maximum 10 points), "physical role functioning" (maximum 4 points), "emotional role functioning" (3 points), "psychological well-being" (5 points), "social functioning" (2 points), "vitality" (2 points), "bodily pain" (4 points), "general health" (5 points). The higher the score the greater the quality of life of the person concerned.

The first scientific analysis of the ESCAT study (performed by the North Rhine Westphalia Heart Centre, Bad Oeynhausen) is interesting: Before the operation patients show a distinctly low quality of life. Only six months after the operation this picture has changed noticeably. Our patients now have approximately the same quality of life as a comparable group without cardiovascular disease. However, a further questionnaire after 12 months shows no further increase in quality of life.

Older patients, in particular, do not feel rejected by others after a heart valve operation. They are less afraid of complications, feel more physically fit and do not complain of annoying valve noises. They reorganize and restructure their lives and have a distinctly higher quality of life after such an operation.
It can be concluded from this that the age limit for heart valve replacement cannot - as in other western European countries - be arbitrarily set at 70 years.

A "healthy heart" again after six months
On the basis of these findings we give our patients the following advice: If you have to have a heart valve operation, six months after the operation your quality of life will be approximately the same as that of a normal person without heart disease. You will be able to live a normal life, cope with normal physical stress and pursue normal leisure activities including travel to far-away countries, provided that you keep your blood clotting within your "individual therapeutic target range" at your destination. Of course, coagulation self-monitoring will enable you to do this.

Dr. med. Heinrich Koertke, Heart- and Diabetes-Center North-Rhine-Westphalia, Georgstr. 11, 32545 Bad Oeynhausen (2004)

 
„Notice to patients:

Please speak to your Doctor before taking any medication other than that which has been prescribed by them. Please always tell the pharmacist that you are on oral anticoagulation therapy when purchasing any medication over the counter. This applies to creams and gels als well as tablets.

Speak to your Doctor before applying any therapy subsequent to the aforementioned information.“