One-year postprocedural quality of life following mitral valve surgery: data from The Netherlands heart registration

OBJECTIVES: The aim of surgical treatment of mitral valve disease is to reverse heart failure and to restore life expectancy and quality of life (QoL). In mitral valve surgery, QoL has not been studied extensively, especially regarding the surgical approach. The current study aimed to evaluate QoL after mitral valve surgery through full sternotomy and a minimally invasive approach (minimally invasive mitral valve surgery). METHODS: All patients undergoing mitral valve surgery between 2013 and 2018 through sternotomy or a minimally invasive mitral valve surgery approach (right anterolateral mini-thoracotomy, sternal-sparing), with or without concomitant tricuspid valve surgery, surgical ablation or atrial septal defect closure were eligible for inclusion in this multicentre nationwide registry in the Netherlands. QoL was measured using the 12- and 36-item short form surveys, before surgery and postoperatively at 1 year. Independent predictors for loss of QoL were evaluated. RESULTS: A total of 485 patients were included (full sternotomy: n = 276, and minimally invasive mitral valve surgery: n = 209). Overall, patients experienced a significant increase in physical component score [56 (42-75) vs 74 (57-88), P < 0.001] and mental component score at 1 year [63 (52-74) vs 70 (59-86), P < 0.001]. Baseline QoL scores and new onset of atrial arrhythmia were independently associated with a clinically relevant reduction in physical and mental QoL. CONCLUSIONS: Mitral valve surgery is associated with significant improvement in physical and mental QoL. Baseline QoL scores and new onset of atrial arrhythmia are associated with a clinically relevant reduction in postoperative QoL.