Ann Thorac Surg 2006;82:1168
© 2006 The Society of Thoracic Surgeons
Correspondence
Reply
Giovanni Battista Luciani, MD,
Alessandro Mazzucco, MD
Division of Cardiac Surgery, University of Verona, O.C.M. Piazzale Stefani 1, Verona, 37126 Italy
(Email: gbluciani{at}yahoo.com).
To the Editor:
We thank Moons and associates [1] for their thought-provoking letter on more rigorous methods to define quality of life after cardiac operations, which comments upon our study [2]. Clearly cardiac surgeons in general have thus far devoted limited efforts in the assessment of such an endpoint, being more focused on survival, major adverse cardiovascular events, and so forth. The issue becomes even more pertinent in patients who have grown into adulthood after pediatric cardiac repair.
In reply to the letter of Moons and colleagues [1], we would only like to make two comments. First, the definition of quality of life remains somewhat elusive. Although it is intuitive that self-perceived health and social status may be of primary importance, thus validating clinical research studies such as the ones by Moons and associates [3–5], objective measures of overall functional status (ie, activity) may be as important. Thus, the New York Heart Association or similar functional class scales, school attendance, employment status, and the ability to exercise should, in our opinion, never be underestimated. In fact, if we as clinicians can do only little to influence the perception our patients have of their health status, we can do a lot to affect their ability to physically function and interact with their peers. Second, the condition of grown-up with congenital heart disease (GUCH) is objectively and, most likely subjectively, somewhat different from the one of a young patient with chronic aortic valve disease, due to variability in disease severity. Therefore, as we agree that more appropriate methods to assess quality of life after the Ross procedure should be adopted, we are not entirely convinced that inferences drawn on GUCH patients should be transferred tout court to patients having cardiac valve operations.
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References
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- Moons P, Van Deyk K, Budts W. The NYHA classification, employment, and physical activities are poor indicators of quality of life after congenital cardiac surgery (letter) Ann Thorac Surg 2006;82:1167-1168.[Free Full Text]
- Luciani GB, Favaro A, Casali G, Santini F, Mazzucco A. Ross operation in the younga ten-year experience. Ann Thorac Surg 2005;80:2271-2277.[Abstract/Free Full Text]
- Moons P, Van Deyk K, Budts W, De Geest S. Caliber of quality-of-life assessments in congenital heart diseasea plea for more conceptual and methodological rigor. Arch Pediatr Adolesc Med 2004;158:1062-1069.[Abstract/Free Full Text]
- Moons P, Van Deyk K, De Geest S, Gewillig M, Budts W. Is the severity of congenital heart disease associated with the quality of life and perceived health of adult patients? Heart 2005;91:1193-1198.[Abstract/Free Full Text]
- Moons P, Van Deyk K, Marquet K, et al. Individual quality of life in adults with congenital heart diseasea paradigm shift. Eur Heart J 2005;26:298-307.[Abstract/Free Full Text]
Related Article
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The NYHA Classification, Employment, and Physical Activities are Poor Indicators of Quality of Life After Congenital Cardiac Surgery
- Philip Moons, Kristien Van Deyk, and Werner Budts
Ann. Thorac. Surg. 2006 82: 1167-1168.
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