Quality of life and survival in patients after assist device implantation

Objectives: Our purpose was to assess mid-term quality of life with the SF-36 questionnaire in patients with postcardiotomy-syndrome and ventricular assist device (VAD).

Methods: Between January 1993 and April 2003 a total of 11904 patients underwent cardiac surgery at our institution. 182 patients (1.5%) needed a postoperative VAD. Mean age was 60±17 years at operation. There were 9 pediatric patients, 52 women, and 121 male patients. 30-day mortality rate was 65% (119 patients). No patients were lost to follow-up. During a follow-up of 35±34 months 27 patients (43%) died. All 36 remaining patients (57%) were mailed a SF-36 questionnaire and 31 (86%) were answered correctly. Four patients refused to answer the questionnaire, and one patients with a cerebral stroke five years after surgery was unable to response the questionnaire.

Results: The Physical Health summary score of the VAD patients (44.4±9.8) was comparable to the healthy German population (44.8±8.1). VAD patients (42.4±9.5) had a significantly (p<0.0001) lower mental health summary score (healthy population: 53.1±7.9). On the other hand VAD patients did not show any difference in the SF-36 summary scores when compared to a matched group of 625 patients after cardiac surgery without VAD.

Conclusion: Patients with postcardiotomy-syndrome have still a high mortality rate, but they show a good mid-term quality of life comparable to other patients after cardiac procedures not complicated by postoperative ventricular failure.