Aortic Valve Stenosis Clinical Trial
Official title:
Health-related Quality of Life, Satisfaction and Outcomes After Ministernotomy Versus Full Sternotomy Aortic Valve Replacement. A Randomized Controlled Trial (QUALITY-AVR TRIAL)
This is a single-center, single-blind, all comer, randomized controlled trial. Patients scheduled for isolated aortic valve replacement (AVR) due to aortic stenosis at "Virgen de la Victoria Universitary Hospital", Málaga, Spain, will be eligible. Ninety-six patients will be randomly assigned to either partial upper sternotomy (ministernotomy, 48 patients) or full sternotomy AVR (48 patients). Sample size was determined for an Alpha error of 0.05,and Beta error of 0.1 for a power of 90% in detecting 0.10 difference points in quality of life EQ-5D-5L-index or 10 points in EQ-5D-5L-Visual Analogic Scale (QOL).
This is a single-center, single-blind, all comer, randomized controlled trial. Patients
scheduled for isolated aortic valve replacement (AVR) due to aortic stenosis at "Virgen de la
Victoria Universitary Hospital", Málaga, Spain, will be eligible. Ninety-six patients will be
randomly assigned to either partial upper sternotomy (ministernotomy, 48 patients) or full
sternotomy AVR (48 patients). Sample size was determined for an Alpha error of 0.05,and Beta
error of 0.1 for a power of 90% in detecting 0.10 difference points in quality of life
EQ-5D-5L-index or 10 points in EQ-5D-5L-Visual Analogic Scale.
Inclusion criteria is severe aortic stenosis referred for medically indicated isolated aortic
valve replacement due to aortic stenosis in patients >18 years.
Exclusion criteria are left ventricular ejection fraction less than 40%, previous cardiac
surgery, urgent/emergent surgery, infective endocarditis, need of concomitant procedures
other than isolated Morrow miectomy and thorax deformity.
CE-marked and FDA-approved mechanical (Sorin Carbomedics®) and stented bioprosthetic aortic
valves will be implanted (Carpentier Edwards Perimount® and Sorin Crown®). Perceval S
Sutureless bioprosthetic valves (LivaNova®) could be used if needed in very small aortic
annulus or high risk patients Quality of Life postoperative outcomes will be assessed, as QOL
measurements and health status with the EQ-5D-5L® questionnaire (QOL index, health visual
analogic scale, severity index and health index), repeatedly assessed preoperatively and
postoperatively at 1-6-12 months. Clinical postoperative complications and outcomes will be
registered at 1 month and 1 year as main secondary and safety end-point (combined end-point
of 4 and 6 major complications) Patient Satisfaction will be assessed with a 20 question
cardiac-surgery specific satisfaction questionnaire (SATISCORE®).
Survival will be assessed at 1 year. Clinical pre and postoperative characteristics will be
registered. Routine blood sampling will be performed pre- and postoperatively. All available
data will be collected prospectively. Informed consent) will be obtained from patients
meeting the inclusion criteria before the initiation of any study-specific procedures.
The Institutional Review Board Ethic Comittee approved this study.
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