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Mitral valve replacement in the elderly is associated with low mortality and similar survival to the general

Victor Dayan1, Gerardo Soca, Leandro Cura

  • 1Division of Cardiac Surgery, National Institute of Cardiac Surgery, Montevideo, Uruguay - victor_dayan@hotmail.com.

The Journal of Cardiovascular Surgery
|January 16, 2016
PubMed

Insights

Mitral valve replacement surgery in elderly patients demonstrates feasible outcomes. While operative mortality has decreased, long-term survival is comparable to the general population, particularly for females.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Geriatric Medicine

Background:

  • Increasing elderly population leads to higher incidence of mitral regurgitation.
  • Elderly patients often denied mitral valve surgery due to perceived poor outcomes.
  • Mitral valve replacement is the preferred procedure in this center.

Purpose of the Study:

  • Analyze early and late survival in elderly patients undergoing mitral valve replacement.
  • Evaluate the feasibility and outcomes of mitral valve surgery in older adults.
  • Compare survival rates of elderly patients to the general population.

Main Methods:

  • Retrospective analysis of patients over 70 undergoing first-time isolated mitral valve replacement (2000-2012).
  • Comparison of observed survival with expected survival in the Uruguayan population.
  • Identification of independent predictors for operative mortality and survival.

Main Results:

  • Global operative mortality was 9.4%, significantly lower after 2006 (1.8% vs. 15.3%).
  • Pre-2006 surgery, low hematocrit, and high creatinine predicted operative mortality.
  • 6-year survival was 70.2% for females (similar to expected) and 40.1% for males (lower than expected).

Conclusions:

  • Mitral valve replacement is a viable option for elderly patients with mitral valve disease.
  • Centers focusing on replacement can achieve low operative mortality.
  • Survival rates are comparable to the general population, especially in females.
Abstract

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