Surgical Correction of Mitral Regurgitation in the Elderly: Outcomes and Recent Improvements

Abstract

Background-In the elderly, mitral regurgitation (MR) is frequent, but surgery risks are considered high. Benefits and indications of MR surgery are uncertain in the elderly. Methods and Results-Baseline characteristics, outcome, and trends for surgical results improvement were analyzed in elderly patients (Ն75 years of age; nϭ284) operated on for MR in 1980 to 1995 compared with younger patients (65 to 74 years of age, nϭ504; and Ͻ65 years of age, nϭ556). Preoperatively, class III to IV symptoms, atrial fibrillation, coronary disease, creatinine, and comorbidity index were more severe in elderly patients (all PϽ0.002). In the long term after surgery, observed survival stratified by age (Ն75, 65 to 74, Ͻ65 years) was lower in elderly than in younger patients (at 5 years, 57Ϯ3%, 73Ϯ2%, and 85Ϯ2%, respectively; PϽ0.001), but ratios of observed to expected survival were similar (83%, 85%, and 88%, respectively