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Mitral valve replacement in the elderly.

N Nicolaou, R H Kinsley

    South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
    |April 14, 1984
    PubMed
    Summary
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    This study reports on mitral valve replacement in elderly patients over 70. High early and late mortality rates were observed, with several patient-related risk factors identified.

    Area of Science:

    • Cardiology
    • Cardiac Surgery
    • Geriatric Medicine

    Background:

    • Mitral valve disease significantly impacts elderly patients.
    • Surgical interventions like mitral valve replacement (MVR) are complex in this demographic.
    • Understanding outcomes and risk factors is crucial for patient management.

    Purpose of the Study:

    • To report the outcomes of elective mitral valve replacement in patients over 70 years old.
    • To identify patient-related risk factors associated with mortality after MVR in this age group.

    Main Methods:

    • Retrospective analysis of 35 patients aged over 70 undergoing elective mitral valve replacement.
    • Data collected between January 1978 and June 1982.
    • Follow-up averaged 25.1 months to assess mortality.

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    Main Results:

    • Early mortality rate was 22.8%.
    • Late mortality rate was 17.1% during the follow-up period.
    • Identified risk factors included chronic mitral stenosis, prior mitral valvotomy, elevated cardiothoracic ratio, pulmonary hypertension, tricuspid incompetence, and high left ventricular end-diastolic pressure.

    Conclusions:

    • Elective mitral valve replacement in patients over 70 carries significant early and late mortality risks.
    • Pre-existing cardiac conditions and anatomical factors are critical risk factors.
    • Careful patient selection and risk assessment are paramount for this procedure in the elderly.