Surgical Scarring and Psychosocial Health After Aortic Valve Surgery: A Narrative Review.

Abstract

Recovery after aortic valve surgery is commonly described in terms of survival, cardiac function, symptoms and health-related quality of life. For younger adults, however, recovery can also involve changes in how the body is perceived and how comfortably a person participates in everyday social life. A visible chest scar, particularly after median sternotomy, may become a lasting reminder of surgery and may carry different meanings for different people. Some individuals may view the scar as evidence of survival, whereas others may experience self-consciousness, concerns about appearance or reluctance to expose the scar in social situations. Evidence from cardiac and broader surgical populations suggests that scar characteristics and perceptions of appearance can be related to body-image concerns and psychosocial well-being. Studies in young adults with congenital heart disease have also linked cardiac-scar-related body-image concerns with anxiety and depressive symptoms. Recent research in younger adults undergoing cardiac surgery suggests that perceptions of chest appearance are associated with body image and that body image is relevant to health-related quality of life. This narrative mini-review brings these strands of evidence together from a public health perspective. It focuses on body image, anticipated social judgement, illness identity, interpersonal relationships and social reintegration after aortic valve surgery. The review also considers how these issues could be incorporated into cardiac rehabilitation and survivorship care. The available evidence remains indirect in important respects, and there is a need for longitudinal and culturally diverse research specifically involving young adults after aortic valve surgery.