Clinical outcomes of mitral valve repair for degenerative mitral regurgitation in elderly patients. (9th May 2022)

• Record Type: Journal Article
• Authors: Kawajiri, Hidetake; Schaff, Hartzell V; Dearani, Joseph A; Daly, Richard C; Greason, Kevin L; Arghami, Arman; Rowse, Philip G; Viehman, Jason K; Lahr, Brian D; Gallego-Navarro, Carlos; Crestanello, Juan A
• Is Part Of: European journal of cardio-thoracic surgery. Volume 62:Number 2(2022)
• Publication Date: 2022-05-09
• Subjects: Mitral valve repair -- Degenerative mitral valve regurgitation -- Elderly patients; Heart -- Surgery -- Periodicals; Chest -- Surgery -- Periodicals; 617.54
• DOI: 10.1093/ejcts/ezac299
• Languages: English
• ISSNs: 1010-7940

Abstract

Abstract: OBJECTIVES: This study analyzes the safety and outcomes of mitral valve repair for degenerative mitral valve regurgitation in patients 75 years of age or older. METHODS: We retrospectively reviewed the clinical results of 343 patients aged ≥75 years who underwent mitral valve repair for degenerative mitral valve regurgitation as a primary indication between January 1998 and June 2017. RESULTS: The median (interquartile range) age of the patients was 79.4 (76.9, 82.9) years, and 132 (38.5%) patients were women. Concomitant procedures were performed in 123 patients: tricuspid surgery in 68 (19.8%) and a maze procedure or pulmonary vein isolation in 55 (16.0%). Operative mortality was 1.2%. Operative complications included atrial fibrillation in 37.9%, prolonged ventilation in 7.0%, pacemaker implantation in 3.8, renal failure requiring dialysis in 1.5 and stroke in 3 (0.9%). The median follow-up was 7.4 years (interquartile range, 3.5–14.1 years). The cumulative incidence rates of mitral valve reoperation were 2.2%, 3.2% and 3.2% at 1, 5 and 10 years, respectively. Overall survival at 1, 5 and 10 years were 95%, 83% and 51%, respectively. Older age, smoking and over and underweight were associated with increased risk of mortality, while higher left ventricular ejection fraction and hypertension were associated with reduced risk. CONCLUSIONS: Mitral valve repair in elderly patients can be accomplished with low operative mortality and complications. Mitral valve repair in the elderly remains the preferred treatment for degenerative mitral regurgitation. Abstract : Mitral valve repair is the preferred treatment for degenerative mitral valve regurgitation.