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ORIGINAL ARTICLE  AORTIC DISEASE Freefree

International Angiology 2019 February;38(1):46-53

DOI: 10.23736/S0392-9590.18.04009-9

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Health-related quality of life one year after surgical treatment of the type I chronic aortic dissection

Oksana KAMENSKAYA 1, Asya KLINKOVA 1 , Irina LOGINOVA 1, Alexander CHERNYAVSKIY 2, Dmitry SIROTA 2, Vladimir V. LOMIVOROTOV 3, Alexander KARASKOV 4

1 Department of Physiology, E. Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, Novosibirsk, Russia; 2 Department of Cardiac Surgery, E. Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, Novosibirsk, Russia; 3 Department of Anesthesia and Intensive Care, E. Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, Novosibirsk, Russia; 4 E. Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, Novosibirsk, Russia



BACKGROUND: The purpose of our study was to assess the health-related quality of life (HRQoL) in patients with type I chronic aortic dissection before and one year after prosthetics of the aorta, and to test the hypothesis that long-term postoperative parameters of HRQoL are affected by clinical determinants related to the underlying disease, intraoperative characteristics, and complications of the early postoperative period.
METHODS: This prospective cohort study included 82 patients with type I chronic aortic dissection. HRQoL parameters were examined using the Short-Form 36 Health Survey Questionnaire before and one year after surgery.
RESULTS: Patients with aortic dissection one year after surgery demonstrated an improvement in many HRQoL parameters, including two summary measures of the questionnaire - Physical component summary (PCS) and Mental component summary (MCS). A lower level of PCS and MCS at the preoperative stage significantly predicted lower values of these indices for a long time after aortic prosthetics. The neurological complications in the early postoperative period were the factor affecting the MCS after surgery. Moreover, the neurological complications and the presence of coronary artery disease increased the risk of the adverse outcomes, including aortic related death and significant decrease of MCS or aortic related death and significant decrease of PCS one year after the operation, respectively.
CONCLUSIONS: Surgical treatment in patients with type I chronic aortic dissection leads to an increase of many HRQoL parameters. Factors affecting MCS and PCS one year after surgery included the neurological complications and lower level of the MCS and PCS at the preoperative stage. Furthermore, the neurological complications and the presence of coronary artery disease increased the risk of the combined endpoints - aortic related death and significant decrease of MCS or aortic related death and significant decrease of PCS one year after the operation, respectively.


KEY WORDS: Quality of life - Aorta, thoracic - Aneurysm, dissecting

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