Is Mitral Valve Repair Superior to Replacement in Elderly Patients?

Ailawadi, Gorav; Swenson, Brian R.; Girotti, Micah E.; Gazoni, Leo M.; Peeler, Benjamin B.; Kern, John A.; Fedoruk, Lynn M.; Krön, Irving L.

doi:10.1016/j.athoracsur.2008.03.020

Cited by 59 publications

(55 citation statements)

References 21 publications

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“…There has been increasing discussion on the greater risks of cardiac surgery for the elderly. [2][3][4][5][6] On the other hand, over the past decade, technical improvements in cardiac surgery, better methods of myocardial protection, and advances in perioperative care have made valve surgery a viable option even for elderly patients. 3,7) Combined valve surgery requires longer operative times because of time required for CPB and AXC.…”

Section: Discussionmentioning

confidence: 99%

Isolated and Combined Valve Surgery in Elderly Patients: A Comparison of Mid-Term Results

Yoneyama

Tokunaga

Enomoto

et al. 2017

ATCS

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Section: Discussionmentioning

confidence: 99%

Isolated and Combined Valve Surgery in Elderly Patients: A Comparison of Mid-Term Results

Yoneyama

Tokunaga

Enomoto

et al. 2017

ATCS

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“…The remaining 48 articles were selected for full-text reading, of which 41 reports that failed to meet the eligibility criteria were eliminated. Consequently, seven observational studies (11)(12)(13)(14)(15)(16)(17) that were published from 2004 to 2016 were included in our meta-analysis.…”

Section: Study Searchmentioning

confidence: 99%

Mitral valve repair versus replacement in elderly patients: a systematic review and meta-analysis

Shang¹,

Lü²,

Liu³

et al. 2017

J. Thorac. Dis.

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Background: Although mitral valve repair (MVP) is generally accepted as the standard treatment for mitral valve disease, in older patients, there is increasing debate about whether MVP is superior to mitral valve replacement (MVR). We, therefore, performed a meta-analysis to compare MVP vs. MVR in the elderly population. 0.56-0.86). In addition, our study also demonstrated improved 1-year (RR: 1.16, 95% CI: 1.08-1.24) and 5-year (RR: 1.26, 95% CI: 1.13-1.41) survival rates following MVP. There was no difference in reoperations between these two surgery approaches. Conclusions:The present meta-analysis indicates that elderly patients who receive MVP have better early and late outcomes than those undergoing MVR. MVP may be the preferred strategy for mitral valve surgery in the elderly population.

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“…This was lower than that reported in previous reports. Ailawadi, et al reported that 30-day mortality after mitral valve repair in patients aged ≥75 years was 7.1% of 70 patients 16) and Nloga, et al reported that the in-hospital mortality after mitral valve repair was 2.7% of 75 octogenarian patients. 21) In terms of operative morbidity, Detaint, et al reported that the incidence of postoperative morbidity decreased with time, although 4%-26% of patients showed postoperative low cardiac output syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…19) Some authors compared the surgical outcomes of repair and replacement and concluded that mitral valve repair was superior to replacement. 16,[18][19][20] Nloga, et al compared the surgical outcomes of mitral valve repair with those of replacement in octogenarians. They concluded that mitral valve replacement was an independent predictor of higher operative mortality.…”

Section: Discussionmentioning

confidence: 99%

“…14,15) In terms of surgical techniques, mitral valve repair was initially considered to be an unnecessary procedure in elderly patients, but the repair rate continues to grow due to improvement in surgical techiniques. 10,[16][17][18] Detaint, et al reported that the repair rate has increased with time and exceeds 80% even in the elderly. 19) Some authors compared the surgical outcomes of repair and replacement and concluded that mitral valve repair was superior to replacement.…”

Section: Discussionmentioning

confidence: 99%

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Feasibility and Efficacy of Mitral Valve Repair for Degenerative Mitral Regurgitation in the Elderly

Murashita

Okada

Kanemitsu

et al. 2014

ATCS

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Purpose: The number of elderly patients who require surgical treatment for mitral regurgitation (MR) is increasing. However, the feasibility and efficacy of mitral valve repair in elderly patients are unclear. Methods: We retrospectively reviewed 55 patients, aged ≥75 years, who underwent mitral valve repair for degenerative MR between 1991 and 2011. All patients were followed up for 4.7 ± 3.4 years. Results: The patients aged ≥75 years were more symptomatic and had a higher incidence of persistent atrial fibrillation and pulmonary hypertension than those aged <75 years. Thirty-day and in-hospital mortality was 1.8% and 7.3%, respectively, and the 5-year survival rate was 81.6% ± 5.8%. The leading cause of late death was stroke, which primarily occurred in patients with postoperative atrial fibrillation. Except for a single failure of repair due to technical reasons, there was no recurrence of severe MR or reoperation on the mitral valve. In the late follow-up period, the mean left ventricular diastolic diameter significantly decreased and the mean left ventricular ejection fraction was approximately 60%. Most patients had mild symptoms at follow-up. Conclusion: Mitral valve repair can provide satisfactory early as well as long-term outcomes and can preserve left ventricular function even in the elderly.

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Is Mitral Valve Repair Superior to Replacement in Elderly Patients?

Cited by 59 publications

References 21 publications

Isolated and Combined Valve Surgery in Elderly Patients: A Comparison of Mid-Term Results

Isolated and Combined Valve Surgery in Elderly Patients: A Comparison of Mid-Term Results

Mitral valve repair versus replacement in elderly patients: a systematic review and meta-analysis

Feasibility and Efficacy of Mitral Valve Repair for Degenerative Mitral Regurgitation in the Elderly

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