Abstract
Background Impending cardiac surgery presents an existential experience that may induce psychological
trauma. Moreover, quality of life long after successful coronary artery bypass graft
surgery (CABG) can be impaired.
Aim The aim of this study was to describe the time course of anxiety and depression in
patients undergoing mitral valve surgery and compare it with our earlier results of
patients undergoing CABG, a disease that is likely to be related to psychosomatic
disorders. We hypothesized that patients undergoing mitral valve surgery can better
manage stresses of cardiac surgery than patients undergoing CABG.
Patients and Methods Of 117 patients undergoing mitral valve surgery, 100 patients (22 to 87 years; 53
females) completed the study and were interviewed before (pre), 1 week after (early),
and 6 months after (late) surgery. The Hospital Anxiety and Depression Scale (HADS)
was employed.
Results The proportion of patients with elevated anxiety scores (AS ≥ 8) was higher than
normal (19.8%): pre, 33.0%; early, 28.0%; and was normalized late (18.0%). Similarly,
depression scores (DS ≥ 8) were increased: pre, 15.0%; early, 20.0%; and late 14.0%,
respectively (normal: 3.2%).
Conclusion Coronary heart disease of CABG patients is presented as a systemic disorder, associated
with both higher and postoperatively increased distress levels than in mitral valve
patients. Anxiety and depression should be recognized as possible symptoms of psychosomatic
disorders necessitating psychotherapeutic intervention to prevent postoperative depression
and warrant patient-perceived surgical outcome that is additionally affected by expectations
with respect to treatment and individual coping capacities. HADS is recommended to
screen for vulnerable patients in the clinical routine, and psychosomatic support
should be provided.
Keywords
mitral valve - surgery - anxiety - depression - development
