Lebensqualität nach aortenklappenersatz: Selbstmanagement oder konventionelle antikoagulationstherapie nach mechanischem klappenersatz versus pulmonaler autograft

Background: The improvement of quality of life gains increasing importance for the judgement of operative techniques. Besides the commonly used mechanical substitutes or bioprostheses for aortic valve replacement, the interest in the Ross procedure is growing. The aim of the study was to compare the quality of life after the Ross procedure with that after mechanical aortic valve replacement with two different anticoagulation regimes (self-management or conventional therapy). Methods and results: Clinical, echocardiographic and quality of life investigations (SF-36) were performed in patients with mechanical aortic valve replacement and self-management of anticoagulation (group A, n=20) or conventional anticoagulation therapy (group B, n=20) and in patients after the Ross procedure (group C, n=20). The mean ages were 59.5 ± 9.2 (group A), 61.2 ± 8.1 (group B) and 59.3 ± 9 years (group C). Significantly lower values of quality of life (SF-36) were observed in group B compared with group A (5 of 9 subtests) and with group C (6 of 9 subtests) and also in the physical and mental health sum scales. Conclusion: In this study the quality of life in patients after the Ross procedure and similarly after mechanical valve replacement and self-management of anticoagulation is superior to the quality of life after mechanical valve replacement and conventional anticoagulation.