Mitral valve repair in the elderly

Operative risk for patients over 70 years of age is acceptable

Richard Lee, Thoralf M. Sundt, M. R. Moon, M. K. Pasque, H. B. Barner, R. J. Damiano, W. A. Gay

Research output: Contribution to journalReview article

Abstract

Aim. Mitral valve repair for degenerative disease is widely accepted. Because of low risk and excellent late outcomes, surgical intervention is recommended increasingly early when repair appears possible. The place of repair vis a vis continued medical therapy in the elderly, however, is less well defined as there are scant data on their surgical risk. We reviewed our recent results with mitral valvuloplasty for degenerative disease with attention to the influence of age. Methods. Thirty-day results of mitral valvuloplasty for degenerative disease between January 1996 and April 2000 were examined retrospectively. Patients with ischemic etiology were excluded. Results among those over age 70 years were compared with younger patients. Results. Of 140 patients (78 men and 62 women) aged 27 to 91 (mean 62±13) years (44≥70 years of age), 61 underwent isolated mitral valvuloplasty, 71 mitral valvuloplasty and coronary artery bypass, and 8 mitral valvuloplasty with other procedures. By multivariate analysis preoperative cardiogenic shock (0.001), but not age, was as a risk factor for death. Among patients stratified by age ≥ or <70, there were differences in atrial fibrillation (47.7% vs 29.2%, p=0.03), prolonged ventilation (31.8% vs 15.6%, p=0.03) and hospital stay (median 9.5, range 5-285 vs median 6.5, range 2-36, p=0.001), but not 30-day readmission (15.9% vs 22.9%) or death (5.2% vs 9.1%, p=0.49). Conclusion. Operative results for mitral valvuloplasty in the elderly are acceptable. Surgery should not be withheld on the basis of age alone.

Original languageEnglish (US)
Pages (from-to)157-161
Number of pages5
JournalJournal of Cardiovascular Surgery
Volume44
Issue number2
StatePublished - Apr 1 2003
Externally publishedYes

Fingerprint

Mitral Valve
Cardiogenic Shock
Coronary Artery Bypass
Atrial Fibrillation
Ventilation
Length of Stay
Multivariate Analysis
Therapeutics

Keywords

  • Aged
  • Aged, 80 and over
  • Atherosclerosis
  • Coronary artery bypass
  • Mitral valve, insufficiency
  • Mitral valve, surgery

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Lee, R., Sundt, T. M., Moon, M. R., Pasque, M. K., Barner, H. B., Damiano, R. J., & Gay, W. A. (2003). Mitral valve repair in the elderly: Operative risk for patients over 70 years of age is acceptable. Journal of Cardiovascular Surgery, 44(2), 157-161.

Mitral valve repair in the elderly : Operative risk for patients over 70 years of age is acceptable. / Lee, Richard; Sundt, Thoralf M.; Moon, M. R.; Pasque, M. K.; Barner, H. B.; Damiano, R. J.; Gay, W. A.

In: Journal of Cardiovascular Surgery, Vol. 44, No. 2, 01.04.2003, p. 157-161.

Research output: Contribution to journalReview article

Lee, R, Sundt, TM, Moon, MR, Pasque, MK, Barner, HB, Damiano, RJ & Gay, WA 2003, 'Mitral valve repair in the elderly: Operative risk for patients over 70 years of age is acceptable', Journal of Cardiovascular Surgery, vol. 44, no. 2, pp. 157-161.
Lee, Richard ; Sundt, Thoralf M. ; Moon, M. R. ; Pasque, M. K. ; Barner, H. B. ; Damiano, R. J. ; Gay, W. A. / Mitral valve repair in the elderly : Operative risk for patients over 70 years of age is acceptable. In: Journal of Cardiovascular Surgery. 2003 ; Vol. 44, No. 2. pp. 157-161.
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abstract = "Aim. Mitral valve repair for degenerative disease is widely accepted. Because of low risk and excellent late outcomes, surgical intervention is recommended increasingly early when repair appears possible. The place of repair vis a vis continued medical therapy in the elderly, however, is less well defined as there are scant data on their surgical risk. We reviewed our recent results with mitral valvuloplasty for degenerative disease with attention to the influence of age. Methods. Thirty-day results of mitral valvuloplasty for degenerative disease between January 1996 and April 2000 were examined retrospectively. Patients with ischemic etiology were excluded. Results among those over age 70 years were compared with younger patients. Results. Of 140 patients (78 men and 62 women) aged 27 to 91 (mean 62±13) years (44≥70 years of age), 61 underwent isolated mitral valvuloplasty, 71 mitral valvuloplasty and coronary artery bypass, and 8 mitral valvuloplasty with other procedures. By multivariate analysis preoperative cardiogenic shock (0.001), but not age, was as a risk factor for death. Among patients stratified by age ≥ or <70, there were differences in atrial fibrillation (47.7{\%} vs 29.2{\%}, p=0.03), prolonged ventilation (31.8{\%} vs 15.6{\%}, p=0.03) and hospital stay (median 9.5, range 5-285 vs median 6.5, range 2-36, p=0.001), but not 30-day readmission (15.9{\%} vs 22.9{\%}) or death (5.2{\%} vs 9.1{\%}, p=0.49). Conclusion. Operative results for mitral valvuloplasty in the elderly are acceptable. Surgery should not be withheld on the basis of age alone.",
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T2 - Operative risk for patients over 70 years of age is acceptable

AU - Lee, Richard

AU - Sundt, Thoralf M.

AU - Moon, M. R.

AU - Pasque, M. K.

AU - Barner, H. B.

AU - Damiano, R. J.

AU - Gay, W. A.

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N2 - Aim. Mitral valve repair for degenerative disease is widely accepted. Because of low risk and excellent late outcomes, surgical intervention is recommended increasingly early when repair appears possible. The place of repair vis a vis continued medical therapy in the elderly, however, is less well defined as there are scant data on their surgical risk. We reviewed our recent results with mitral valvuloplasty for degenerative disease with attention to the influence of age. Methods. Thirty-day results of mitral valvuloplasty for degenerative disease between January 1996 and April 2000 were examined retrospectively. Patients with ischemic etiology were excluded. Results among those over age 70 years were compared with younger patients. Results. Of 140 patients (78 men and 62 women) aged 27 to 91 (mean 62±13) years (44≥70 years of age), 61 underwent isolated mitral valvuloplasty, 71 mitral valvuloplasty and coronary artery bypass, and 8 mitral valvuloplasty with other procedures. By multivariate analysis preoperative cardiogenic shock (0.001), but not age, was as a risk factor for death. Among patients stratified by age ≥ or <70, there were differences in atrial fibrillation (47.7% vs 29.2%, p=0.03), prolonged ventilation (31.8% vs 15.6%, p=0.03) and hospital stay (median 9.5, range 5-285 vs median 6.5, range 2-36, p=0.001), but not 30-day readmission (15.9% vs 22.9%) or death (5.2% vs 9.1%, p=0.49). Conclusion. Operative results for mitral valvuloplasty in the elderly are acceptable. Surgery should not be withheld on the basis of age alone.

AB - Aim. Mitral valve repair for degenerative disease is widely accepted. Because of low risk and excellent late outcomes, surgical intervention is recommended increasingly early when repair appears possible. The place of repair vis a vis continued medical therapy in the elderly, however, is less well defined as there are scant data on their surgical risk. We reviewed our recent results with mitral valvuloplasty for degenerative disease with attention to the influence of age. Methods. Thirty-day results of mitral valvuloplasty for degenerative disease between January 1996 and April 2000 were examined retrospectively. Patients with ischemic etiology were excluded. Results among those over age 70 years were compared with younger patients. Results. Of 140 patients (78 men and 62 women) aged 27 to 91 (mean 62±13) years (44≥70 years of age), 61 underwent isolated mitral valvuloplasty, 71 mitral valvuloplasty and coronary artery bypass, and 8 mitral valvuloplasty with other procedures. By multivariate analysis preoperative cardiogenic shock (0.001), but not age, was as a risk factor for death. Among patients stratified by age ≥ or <70, there were differences in atrial fibrillation (47.7% vs 29.2%, p=0.03), prolonged ventilation (31.8% vs 15.6%, p=0.03) and hospital stay (median 9.5, range 5-285 vs median 6.5, range 2-36, p=0.001), but not 30-day readmission (15.9% vs 22.9%) or death (5.2% vs 9.1%, p=0.49). Conclusion. Operative results for mitral valvuloplasty in the elderly are acceptable. Surgery should not be withheld on the basis of age alone.

KW - Aged

KW - Aged, 80 and over

KW - Atherosclerosis

KW - Coronary artery bypass

KW - Mitral valve, insufficiency

KW - Mitral valve, surgery

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EP - 161

JO - Journal of Cardiovascular Surgery

JF - Journal of Cardiovascular Surgery

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