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Pushing the age limit: Mitral valve surgery is safe and effective in octogenarians
Ricky Patil1, Matthew Kazaleh1, China Green1
1Department of Cardiac Surgery, University of Michigan, Ann Arbor, Mich.
The Journal of Thoracic and Cardiovascular Surgery
|July 6, 2026
Summary
Mitral valve surgery in octogenarians is safe and effective. Valve repair, when feasible, offers improved mid-term survival compared to replacement in this elderly population.
Area of Science:
- Cardiovascular Surgery
- Geriatric Cardiology
- Valvular Heart Disease
Background:
- Octogenarians with mitral valve disease are a growing population.
- Transcatheter mitral interventions challenge the role of surgical repair.
- Obstacles to repair include co-morbidities, tissue quality, and limited life expectancy.
Purpose of the Study:
- To evaluate outcomes of mitral valve surgery in octogenarians.
- To compare surgical mitral valve repair versus replacement in this age group.
Main Methods:
- Analysis of 221 patients aged ≥ 80 undergoing mitral surgery (2015-2024).
- Sub-analysis of 168 patients with degenerative mitral regurgitation (DMR).
- Outcomes assessed: operative mortality and mid-term survival.
Main Results:
- Overall operative mortality was 5%, lower for repair (3%) vs. replacement (11%) (p=0.04).
- In DMR patients, operative mortality was 1.2% with no difference by procedure type.
- Mitral valve repair was linked to better mid-term survival up to 4 years (p=0.02).
Conclusions:
- Mitral surgery is safe and effective in selected octogenarians.
- Feasible mitral valve repair enhances mid-term survival.
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