Functional outcome and quality of life in adult patients with congenital heart disease after atrioventricular valve replacement.

Zandstra, T. (Tjitske) (2014) Functional outcome and quality of life in adult patients with congenital heart disease after atrioventricular valve replacement. thesis, Medicine.

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Abstract

Background: The population of adults with congenital heart disease (CHD) has increased greatly over the last decades as a result of increased knowledge. An important part of these patients needs at least one heart valve replacement. This paper aims to explore the exercise capacity, Quality of Life (QoL) and prosthesis-patient mismatch (PPM) for the patients who underwent atrioventricular (mitral or tricuspid) valve replacement within this patient group. Methods: 51 adult CHD patients with a median age of 40.2 years were prospectively included, of which 45 had had mitral valve replacement (MVR) and 6 had had tricuspid valve replacement (TVR). Exercise capacity was tested with a static bicycle or treadmill test, the QoL was assessed with the RAND-36 Health-Related Quality of Life questionnaire and compared with a reference group, and PPM was assessed with transthoracic echocardiography. Results: the median exercise capacity was 59% of expected and was mainly associated with NYHA class (p=0.019), societal participation (p=0.043), and NT-pro-BNP(p=0.045). The QoL was reduced in the study population compared to the reference population in almost all domains of the RAND-36, especially general health perception (p<0.001, effect size=0.89) and was mainly associated with NYHA class (p<0.001), age (p=0.004), and gender (p=0.032). The evaluation of PPM turned out to be complicated in this population but the prevalence of PPM appears to be notable. Conclusions: the present study explored relevant clinical questions in adult CHD patients who underwent AVVR. Exercise capacity and QoL are reduced and PPM occurs frequently. It is important to take these characteristics of this patient population into account.

Item Type:	Thesis (Thesis)
Supervisor name:	Pieper, dr. P.G.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:49
Last Modified:	25 Jun 2020 10:49
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/987

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