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Minimally Invasive Mitral Valve Surgery in the Elderly
Maximilian Franz1, Nunzio Davide De Manna2, Saskia Schulz1
1Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
The Thoracic and Cardiovascular Surgeon
|March 1, 2023
Summary
Minimally invasive mitral valve surgery (miMVS) shows favorable outcomes in elderly patients (≥75 years). This study found no significant differences in 30-day mortality or major complications compared to younger patients.
Area of Science:
- Cardiovascular Surgery
- Geriatric Medicine
- Minimally Invasive Procedures
Background:
- Minimally invasive mitral valve surgery (miMVS) offers reduced trauma, potentially benefiting elderly patients.
- Assessing the safety and efficacy of miMVS in patients aged 75 years and older is crucial.
Purpose of the Study:
- To evaluate the early postoperative outcomes of miMVS in patients aged ≥75 years.
- To compare these outcomes with those of younger patients undergoing miMVS.
Main Methods:
- Retrospective cohort study involving 761 patients who underwent miMVS.
- Propensity score matching created a study group (≥75 years, n=189) and a control group (<75 years, n=189).
- Primary endpoint: 30-day mortality. Secondary endpoints: myocardial infarction, stroke, renal failure.
Main Results:
- Elderly patients had higher rates of NYHA III heart failure preoperatively (60% vs. 46%) and more valve replacements (48% vs. 32%).
- Postoperative ventilation time was longer in the elderly (13 vs. 11 hours).
- No significant differences were observed in 30-day mortality (4% vs. 2%), stroke (3% vs. 0.6%), myocardial infarction (0% vs. 1%), or renal failure (5% vs. 4%).
Conclusions:
- Minimally invasive mitral valve surgery is associated with satisfactory early postoperative outcomes in elderly patients.
- Age ≥75 years is not a significant risk factor for adverse outcomes after miMVS when compared to younger cohorts.
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