[Psycho-social experiences and quality of life of pacemaker patients in Cotonou]. / Vécu psycho-social et qualité de vie des patients porteurs de pacemaker à Cotonou.

PURPOSE OF THE STUDY: The aim was to study the psycho-social experiences and quality of life (QOL) of pacemaker patients at the National Teaching Hospital Hubert Koutoukou Maga in Cotonou. PATIENTS AND METHOD: A descriptive cross-sectional observational study was performed in 2017 and included over a three-month period all pacemaker patients admitted on an ambulatory basis. The psychological impact of wearing a pacemaker was studied, as well as the limits and constraints of daily life and the quality of life appreciated by the SF-36 score. RESULTS: Fifty-five (55) patients were included with an average age of 67 ± 11.3 years. In terms of psychological impact, 98.2% (n=54) had a good overall perception of their health status. However, 60.6% (n=33) perceived pacemaker use as a handicap and 52.5% (n=29) wanted psychological support in post-implantation. Limitations and constraints mainly concerned lateral decubitus on the side of the pacemaker (54.5%, n=30), travel (27.3%, n=15) and sexual relations (21.8%, n=12). The average quality of life was rated good in 6 out of 8 dimensions. The level of quality of life was independent of gender. CONCLUSION: This study has highlighted misperceptions of daily life that may hinder the expected improvement in post-implantation patient performance. Psychological support and enhanced communication with these patients are needed.

[Impact of transcatheter aortic valve implantation in the treatment of aortic valve disease after previous coronary artery bypass]. / Impact des techniques interventionnelles dans le traitement de la valvulopathie aortique après revascularisation myocardique chirurgicale préalable.

INTRODUCTION: Patients with a history of coronary artery bypass and aortic valve disease constitute a high-risk group for conventional redo surgery. The transcatheter aortic valve implantation (TAVI) may be an alternative for high-risk patients. The purpose of this study is to evaluate the impact of TAVI in the treatment of aortic valve disease after previous surgical coronary artery revascularization. PATIENTS AND METHODS: This is a single-center retrospective, observational study, including 87 patients undergoing surgery for surgical heart valve replacement or TAVI from January 2007 to December 2013. RESULTS: The introduction of transcatheter aortic valve implantation techniques has doubled the number of redo patients treated for aortic valve disease. From 2010 to 2013, the patients treated by conventional surgery diminished by 30%, with improved postoperative outcomes. This study allowed us to notice differences in patient's in terms of operative risk factors. For the same reasons no comparison was possible between 2 subgroup of patients. Hospital mortality was 6.4% for conventional aortic surgery and 20% for transcatheter aortic valve treatment. CONCLUSION: Surgery remains the standard treatment for aortic valve disease even in redo patients, but TAVI becomes a very interesting tool as it may represent a tailored approach for our patients.