The disadvantages of mitral valve replacement with a bioprosthesis in the long-term
may not play an important role if the shorter life expectancy of older patients is
taken into account. This study aims to evaluate whether mitral valve replacement in
the elderly is associated with similar outcome compared to repair in the short- and
long-term. All patients aged 70 years and older undergoing minimally invasive mitral
valve surgery were studied retrospectively. Primary outcome was 30-day complication
rate, secondary outcome was long-term survival and freedom from re-operation. 223
Patients underwent surgery (124 replacement and 99 repair) with a mean age of 76.4
± 4.2 years. 30-Day complication rate (replacement 73.4% versus repair 67.7%; p=.433),
30-day mortality (replacement 4.0% versus repair 1.0%; p=.332) and 30-day stroke rate
(replacement 0.0% versus repair 1.0%; p=.910) were similar in both groups. Multivariable
cox regression revealed higher age, diabetes and left ventricular dysfunction as predictors
for reduced long-term survival, while a valve replacement was no predictor for reduced
survival. Sub analysis of patients with degenerative disease showed no difference
in long-term survival after propensity weighting (HR 1.4; 95%CI 0.84 – 2.50; p=.282).
The current study reveals that mitral valve repair and replacement in the elderly
can be achieved with good short- and long-term results. Long-term survival was dependent
on patient related risk factors and not on the type of operation (replacement versus
repair).
Graphical abstract
Graphical Abstract
Keywords
Abbreviations:
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Article info
Publication history
Published online: August 29, 2021
Footnotes
Funding: There were no funding supports.
Informed consent was waived by the IRB (MEC-U; W19.168; 28-08-2019)
Conflicts of Interest: All authors declare no conflict of interests.
Identification
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