Quality of life after heart valve replacement.

Over the last three decades, heart valve replacement has become a safe and routine surgical procedure, but replacement devices are still far from ideal. Despite improvements in materials and design, life-long anticoagulation remains mandatory for mechanical valves. The major shortcoming of the less thrombogenic bioprosthetic valves is early tissue failure. Parallel to the decrease in operative mortality after heart valve replacement, the potential quality of life for survivors has been becoming increasingly important in evaluating the late results and in selecting the appropriate device for the given patient. All factors that determine the quality of life are strongly affected by the operation due to the usually dramatic improvement both in subjective status and objective parameters postoperatively. The patient, thus, can return to normal activities, maintain self-esteem and keep normal relationships at work, in the community and at home. Psychoneurologic dysfunction was also found to decrease greatly within six months, although more than a quarter of patients were depressed preoperatively because of their disease. Overall, the experience was generally satisfying.