Assessment of pain, anxiety and depression, and quality of life after minimally invasive aortic surgery

Background Minimally invasive cardiac surgery may reduce surgical trauma, diminish postoperative pain and improve quality of life (QOL). The aim of this study is to assess pain, hospital anxiety and depression scale (HADS), and QOL in patients undergoing minimally invasive aortic surgery. Methods This is a prospective, single-center cohort study of 24 consecutive patients undergoing upper ministernotomy aortic valve, aortic root, and concomitant aortic valve and ascending aorta replacement. Visual analog scale (VAS) pain scores and HADS and Short-Form-36 (SF-36) questionnaires were evaluated at preoperative baseline, during hospitalization, and at 1 and 3 months postoperatively. Results At discharge, the average VAS pain score was significantly lower than postoperative Day 1 (2.7 +/- 0.4 vs. 6.5 +/- 0.4; p <= .001). By 1 month, the pain scores were not significantly different from baseline (1.7 +/- 0.4 vs. 1.0 +/- 0.4; p = 1.000), and by 3 months, pain scores returned to baseline (1.0 +/- 0.4; p = 1.000). HADS scores show that compared with preoperative baseline, average anxiety scores decreased by 1 month (3.1 +/- 0.7 vs. 4.3 +/- 0.6; p = 1.000) and decreased significantly by 3 months (1.8 +/- 0.7 vs. 4.3 +/- 0.6; p = .012). Additionally, depression scores were unchanged at 1 month (3.0 +/- 0.4 vs. 3.1. +/- 0.4; p = 1.000) and decreased by 3 months (1.3 +/- 0.5 vs. 3.0 +/- 0.4; p = .060). SF-36 scores revealed no changes in scores in 7 of 8 domains at 1 month and a significant increase in "physical functioning," "energy," and "general health" domains compared to preoperative baseline at 3 months. Conclusions Following minimally invasive aortic surgery, VAS pain scores, HADS and scores in 7 of 8 SF-36 domains returned to preoperative baseline or improved compared to preoperative baseline at 1 month. At 3 months, scores in 3 of 8 SF-36 domains significantly improved compared to preoperative baseline. Larger studies are necessary for further investigation.