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[Mitral valve surgery in elderly patients].

M J Antunes1

  • 1Serviço de Cirurgia Cardiotorácica, Hospitais da Universidade de Coimbra. antunes.cct.huc@mail.telepac.pt

Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology
|July 27, 1999
PubMed
Summary
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Elderly patients with mitral valve disease can safely undergo surgery. Mitral valvuloplasty is often preferred over prosthetic replacement, offering durable results with acceptable risks in this population.

Area of Science:

  • Cardiovascular Surgery
  • Geriatric Cardiology
  • Valvular Heart Disease

Context:

  • Increasing life expectancy leads to a growing number of elderly patients with mitral valve pathology.
  • Surgical indications are similar to younger patients, but increased mortality and morbidity necessitate careful patient selection.
  • Optimizing patient condition pre-operatively can significantly reduce surgical risks.

Purpose:

  • To evaluate the feasibility and outcomes of mitral valve surgery in patients over 70 years of age.
  • To compare the risk-benefit ratio of mitral valvuloplasty versus prosthetic valve replacement in the elderly.
  • To determine the safety and efficacy of mitral valvuloplasty for myxomatous mitral regurgitation in geriatric patients.

Summary:

  • Mitral valve surgery was performed on 433 patients over 70 years old (11.6% of total) in Coimbra over 10 years.

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  • Mitral valvuloplasty was successful in over 90% of cases, with an overall mortality rate of 2.6%.
  • Myxomatous mitral regurgitation, prevalent in this age group, showed the most durable results with valvuloplasty.

    • Impact:

    • Mitral valve surgery is a viable option for elderly patients, offering acceptable mortality and morbidity rates.
    • Pre-operative optimization is crucial for successful surgical outcomes in geriatric patients.
    • Mitral valvuloplasty demonstrates superior long-term durability for myxomatous mitral regurgitation in the elderly, making it a preferred option.