Usporedba kvalitete života nakon rekonstrukcije i nakon zamjene korijena aorte

master's thesis

• Title (english): Comparison of quality of life: aortic root reconstruction versus replacement
• Author: Karla Lisica
• Mentor: Igor Rudež (mentor)
• Committee member: Hrvoje Gašparović (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Igor Rudež (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Tradicionalni kirurški pristup aortnoj regurgitaciji (AR) uključuje zamjenu aortnog zaliska
(AVR), no napretkom kirurške tehnike i tehnologije razvijena je mogućnost rekonstrukcije
prirodnog zaliska (AVRep). Razvojem tehnika rekonstrukcije omogućeno je izbjegavanje
svih potencijalnih komplikacija koje umjetni zalisci nose. Dosad provedene studije o
AVRep zahvatima govore u prilog povoljnim ishodima po pitanju mortaliteta, potrebe za
ponovnom operacijom i ostalih komplikacija vezanih uz zaliske, no istraživanja koja se
bave kvalitetom života povezanom sa zdravljem (HRQoL) praktički su u povojima, unatoč
sve većem općem interesu o toj temi. Ipak, dosad objavljenje studije pokazuju da pacijenti
podvrgnuti AVRep generalno pokazuju bolju kvalitetu života u odnosu na one kojima je
učinjena AVR.
Cilj ovog rada bio je usporediti kvalitetu života među pacijentima kojima je aortni zalistak
rekonstruiran (AVRep) i onima kojima je aortni zalistak zamijenjen (AVR).
U razdoblju od četiri godine, 99 je pacijenata podvrgnuto kirurškom zahvatu zbog aortne
regurgitacije. Ovoj se studiji odazvalo njih 46, pri čemu ih je 33 pripadalo AVRep skupini,
a 13 AVR skupini. Postoperativna HRQoL među sudionicima ispitana je standardiziranim
upitnikom RAND-36, koji ispituje 8 dimenzija zdravlja i posebnu kategoriju promjene
zdravlja u odnosu na lani.
Rezultati su pokazali da među skupinama postoji usporediv rezultat u svim dimenzijama
upitnika, no u dvije kategorije (ograničenje zbog fizičkih poteškoća i vitalnost) AVR
skupina postigla je statistički značajno bolji rezultat, što se posebno odnosi na podskupinu
ispitanika starijih od 55 godina.
Ova studija pokazuje da su, kako bi se bolje utvrdila stvarna korelacija između kvalitete
života i odabranog zahvata na korijenu aorte, potrebna daljnja istraživanja na tom
području, naročito na većim uzorcima te s posebnim fokusom na povezanost s dobi.

Abstract (english)

Surgical treatment of aortic regurgitation (AR) traditionally involves aortic valve
replacement (AVR) as an established method of choice. However, development in
surgical techniques and technology has made aortic valve-sparing (AVS) surgeries
possible, therefore saving patient from potential complications which mechanical and
bioprosthetic valves include. Aortic valve repair (AVRep) studies conducted so far have
been reporting promising results considering survival, re-operation and other
complications. Overall increasing interest in health-related quality of life (HRQoL) has
brought attention to possible differences between these surgical options in this field, as
well. Most of the published studies suggest that patients underwent AVRep have
significantly better HRQoL comparing to those who received AVR as a treatment of
choice.
The aim of this study was to compare HRQoL between patients who were treated with
AVRep and those who received AVR.
Within a 4-year period, 99 patients received either an AVRep or AVR. With the response
rate of 48%, this study included 46 patients (AVRep=33, AVR=13) whose HRQoL was
evaluated postoperatively by the RAND-36 health survey.
The results showed that RAND-36 scores were comparable in most of the health
concepts, while in two of them (role limitation due to physical problems and vitality) AVR
group achieved significantly better score, especially in the subgroup of patients over 55
years old.
In conclusion, this study shows that the superiority of the AVRep over the AVR technique
in terms of HRQoL is still not fully reliable and has yet to be explored, especially among
aging patients.

• Keywords: zamjena aortnog zaliska; rekonstrukcija aortnog zaliska; kvaliteta života
• Keywords (english): aortic valve repair; aortic valve replacement; health-related quality of life
• Language: croatian
• URN:NBN: urn:nbn:hr:105:618595
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-11-25 12:17:34