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Emergency mitral valve replacement in the octogenarian
Joseph H Gorman1, Benjamin M Jackson, Daniel M Kolansky
1Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. gormanj@uphs.upenn.edu
The Annals of Thoracic Surgery
|July 5, 2003
Summary
Acute mitral regurgitation in elderly patients with cardiogenic shock presents surgical challenges. This study demonstrates successful surgical outcomes in two octogenarian cases, challenging resource utilization concerns.
Area of Science:
- Cardiovascular Surgery
- Adult Cardiac Surgery
- Critical Care Medicine
Background:
- Acute mitral regurgitation (AMIR) secondary to papillary muscle or chordae tendineae rupture is a rare but severe complication.
- Profound cardiogenic shock in octogenarian patients with AMIR poses significant surgical challenges and ethical considerations regarding resource allocation.
Observation:
- Two cases of octogenarian patients presenting with acute mitral regurgitation and profound cardiogenic shock were analyzed.
- These patients required complex adult cardiac surgery interventions.
Findings:
- Successful surgical management and positive outcomes were achieved in both octogenarian patients.
- The interventions effectively addressed the acute mitral regurgitation and reversed the cardiogenic shock.
Implications:
- This study highlights the feasibility and success of surgical intervention for acute mitral regurgitation in elderly patients, even in critical conditions.
- It challenges the notion that such cases are futile and suggests that aggressive management can be resource-effective, improving patient survival and quality of life.