# The perception of surgical valve disease patients on quality of life improvement through the care line model: a longitudinal study

## TL;DR

This study shows that patients with heart valve disease experience significant quality of life improvements after surgery, especially in mobility, pain, and emotional well-being, when followed through a structured care model.

## Contribution

The study provides novel longitudinal patient-reported quality of life data in surgical valve disease patients within a structured care pathway model in a developing country context.

## Key findings

- EQ-5D and EQ-VAS scores showed substantial improvement in the late postoperative period compared to preoperative assessments.
- SF-36 domains like functional capacity, vitality, and mental health demonstrated significant postoperative improvement.
- Structured care pathways like the Surgical Valve Disease Care Line enhance recovery and patient-centered outcomes.

## Abstract

To evaluate the improvement in the quality of life of surgical cardiac valve disease patients based on their perceptions at three distinct points: preoperative, immediate postoperative, and late postoperative.

Quality of life has been increasingly recognized as a central outcome in cardiovascular care, especially in valvular diseases. Despite the extensive international literature on postoperative recovery and favorable clinical outcomes, few studies have examined quality of life from the patient's perspective within a structured care pathway model, particularly in developing countries such as Brazil. This study contributes by assessing quality of life longitudinally and from the patient's perspective, within an interdisciplinary Care Line Model implemented at a high-complexity cardiovascular center.

This retrospective, observational longitudinal study included patients with significant valvular disease undergoing surgery. These patients were assessed at three time points by the psychology team: preoperative, immediate postoperative (after discharge from the Intensive Care Unit and before hospital discharge), and late postoperative (6 months after hospital discharge). Quality of life was measured from the patients' perspective using two instruments: SF-36 and EQ-5D, as part of the surgical valve disease care model implemented at the institution.

Patients reported significant improvements in quality of life after surgery. The EQ-5D and EQ-VAS scores increased substantially in the late postoperative period compared to preoperative values. SF-36 domains, particularly functional capacity, vitality, pain, general health, and mental health, showed robust improvement. All analyses were based strictly on comparisons between assessment points; no assumptions of linear postoperative improvement were made.

Valve surgery is associated with meaningful improvements in patients’ perceived quality of life, especially regarding mobility, pain/discomfort, self-care, and emotional and social functioning. These findings reinforce the relevance of multidisciplinary and longitudinal follow-up and demonstrate the potential contribution of structured care pathways, such as the Surgical Valve Disease Care Line, to enhance recovery and patient-centered outcomes.