Study: TAVR helps heart, maybe not life quality

PHILADELPHIA, PA.; February 18, 2014

TAVR, or transcatheter aortic valve replacement, threads the new valve into place on a catheter, or wire, rather than through the chest in open surgery.

Hospitals heavily advertise the technique as a way to restore better health and quality of life for people troubled by shortness of breath, dizziness, and chest pains.

In an article published in the current edition of Annals of Internal Medicine, Dr. Dae Hyun Kim of Beth Israel Deaconess Hospital in Boston, and his co-authors say most of the follow-up on TAVR has focused on its safety, not on the promise of improved quality of life.

Doctors at 5 major medical centers looked at reports from thousands of patients who had undergone TAVR since its inception in 2002.

Their research showed that TAVR improved symptoms, heart function and other measures specific to their valve problems. They used a scale known as the New York Heart Association class.

"On the basis of our review of current literature, we conclude that TAVR provides a clinically meaningful improvement in symptoms, physical function, and disease-specific measures of quality of life compared with conservative treatment," the authors wrote.

"The psychological or general health benefits seem to be modest," they continued.

They suggest a need to evaluate the overall effect of TAVR in elderly patients, to identify those who would benefit most. And they say a system is needed to better predict both the clinical success of the procedure and any benefits to a patient's life.

The study authors say more research on this aspect is needed, however, doctors and patients considering TAVR should discuss it before deciding on the procedure.

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