Self-reported quality of life and health among Bjork-Shiley convexo-concave prosthetic heart valve patients

Background and aim of the study: The risk of fracture of Bjork-Shiley conve xo-concave (BSCC) prosthetic heart valves has resulted in consideration of prophylactic explantation and replacement for patients with high-risk valve s. Little information exists on perceived quality of life, health status, a nd serious morbidity among BSCC patients, including those who have undergon e explantation. Methods: Self-administered questionnaires were completed by a cohort of 585 BSCC patients who participated in an X-ray imaging study to detect precurs ors to valve fracture up to seven years (average 3.9 years) previously. Res ponses from 31 explant patients were contrasted with those from 554 BSCC pa tients in whom explant surgery was not attempted. Results: Perceived quality of life and health status and risk of hospitaliz ation after participating in the imaging study varied considerably among pa tients, but on average tended not to differ significantly between those wit h and without explants. A slightly greater proportion of explantees tended to report both improved health status and high rates of heart attack and pa cemaker implantation. The health status of these patients was, in general, considerably worse than previously reported among valve implant patients. O ver half the cohort were hospitalized during follow up, and half were unabl e to walk up more than one flight of stairs without shortness of breath. Conclusion: The less than optimal health status of most BSCC patients and r elatively high rates of morbidity should be taken into account when conside ring potential explantation of the valves.