Minimally Invasive Mitral Valve Surgery in Elderly Patients: Results from a Multicenter Study

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Procedures
• Geriatric Cardiology

Background:

• Minimally invasive mitral valve surgery (MIMVS) is a growing alternative to conventional sternotomy, particularly for younger patients.
• Its application in elderly patients (>75 years) is increasing but yields controversial results.
• This study evaluates MIMVS outcomes in elderly versus younger patients.

Purpose of the Study:

• To assess and compare postoperative outcomes of elderly (>75 years) and younger (<65 years) patients undergoing MIMVS.
• To determine if MIMVS is a safe and effective option for elderly patients.

Main Methods:

• Retrospective analysis of 1113 MIMVS patients (2015-2022) from seven high-volume centers.
• Patients divided into young (<65) and elderly (>75) groups.
• Propensity score matching used to create comparable groups for outcome analysis.

Main Results:

• Elderly patients had higher comorbidity burden and EuroSCORE II.
• No significant difference in postoperative mortality between groups.
• Elderly patients experienced higher rates of complications like bleeding, stroke, and reintubation in unmatched analysis.
• After propensity score matching, no significant differences in postoperative outcomes were observed between groups.

Conclusions:

• Elderly patients, when carefully selected, achieve hospital outcomes comparable to younger patients undergoing MIMVS.
• MIMVS is a viable option for elderly patients, provided appropriate patient selection.
• These findings support the expanded use of MIMVS in suitable elderly populations.