Thorac cardiovasc Surg
DOI: 10.1055/s-0037-1604461
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Anxiety and Depression in Patients Undergoing Mitral Valve Surgery: A Prospective Clinical Study

Katrin Botzet1, Hannan Dalyanoglu1, Ralf Schäfer2, Artur Lichtenberg1, Jochen D. Schipke3, Bernhard Korbmacher1
  • 1Clinic for Cardiovascular Surgery, University Hospital Düsseldorf, Düsseldorf, Germany
  • 2Clinical Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf, Düsseldorf, Germany
  • 3Research Group Experimental Surgery, University Hospital Düsseldorf, Düsseldorf, Germany
Further Information

Publication History

17 April 2017

27 June 2017

Publication Date:
06 August 2017 (eFirst)


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.