Related Experiment Video
Updated: May 31, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Mitral valve repair versus replacement in the elderly population
Sheraz R Markar1, Umar Sadat, Lynn Edmonds
1Department of Cardiothoracic Surgery, Papworth Hospital, Cambridge, UK.
Background And Aim Of The Study:
The study aim was to evaluate the available literature comparing mitral valve repair (MVRep) versus mitral valve replacement (MVR) in the elderly population, and to provide a pooled analysis regarding this issue.
Methods:
Medline, Embase, Cochrane, trial registries, conference proceedings and reference lists were searched for trials of MVRep versus MVR surgery in the elderly population. The primary outcome was 30-day mortality, while secondary outcomes were postoperative complications and length of hospital stay. Pooled odds ratios were calculated for categorical outcomes and weighted mean differences for continuous outcomes.
Results:
Four studies retrieved were deemed appropriate for inclusion. The outcome measures used for the analysis clearly showed a benefit of MVRep in the elderly population with reduced mortality (pooled Odds Ratio (OR) = 3.97; p = 0.003) and reduced postoperative complications (pooled OR = 2.35; p = 0.003). There was no significant difference between the two groups with regards to duration of hospital stay (weighted mean difference = 0.22; p = 0.18).
Conclusion:
With the demonstration of clear advantages of MVRep over MVR in the elderly population, a randomized trial between the two techniques is not ethically justifiable. As there are clear advantages to MVRep, it is recommended that this should be the primary treatment offered in mitral valve pathology, irrespective of the patient's age.
Related Concept Videos
Mitral Stenosis III: Medical Management
Mitral Regurgitation III: Medical Management
Mitral Valve Prolapse II: Assessment and Management
Mitral Valve Prolapse III: Nursing Management
Mitral Regurgitation IV: Nursing Management
Mitral Valve Prolapse I: Introduction

