Clinical Outcomes of Mitral Valve Repair for Degenerative Mitral Regurgitation in Elderly Patients
Objectives: This study analyzes the safety and outcomes of mitral valve repair for degenerative mitral valve regurgitation in patients 75 years 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 (IQR) age of the patients was 79.4 (76.9, 82.9) years, and 132 (38.5%) patients were women. Concomitant procedures were perform in 123 patients: tricuspid surgery in 68 (19.8%). 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 troke in 3 (0.9%). The Median follow-up was 7.4 years (IQR, 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. Old age, smoking, and over and underweight were associated with increases mortality risk, while high left ventricular ejection fraction and hypertension was associate with reduce 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.