Short and long-term results of mitral valve repair in octogenarians

Objective: The optimal strategy for the management of mitral regurgitation in elderly patients is still debated. The increase of cardiac operations in patients aged 80 years or more is a fact. The aim of this study is to analyse the mitral valve procedure in this group of patients.

Methods: Between 2003 and 2009, 46 patients (27 women, 19 men) with chronic mitral regurgitation and New York Heart Association (NYHA) Class I/II underwent mitral valve repair. 24 patients had concomitant coronary artery bypass grafting (CABG). Preoperative and postoperative echocardiography examination was done. Predicted operative mortality was evaluated with Euroscore. Mortality and life tables were studied. Parameters that affect survival were evaluated with Cox regression analysis. p<0.05 was considered statistical significant. Quality of life test was performed.

Results: Mean postoperative follow-up was 42±10 months (Range 1–52 months). Mean age was 84.82±5.81 (80–88). The EF increased from 36.60%±11.21% to 43.92%±10.98%. Postoperative 9 patients suffered of low cardiac output syndrome. Hospital mortality was 6.52%. The 30 days survival was 91.30%, the 12, 24 and 48 months survival was, 86.95%, 80.44% and 65.21% respectively. Risk factors for early mortality were mitral valve repair with concomitant CABG, emergency, acute myocardial infarction, chronic lung disease and depressed systolic function. Predictors for long term mortality were age (p<0.001), depressed systolic function and lung disease.

Conclusion: Mitral valve repair with concomitant CABG can be performed with acceptable morbidity and mortality in octogenarians. A proper selection of patients and the operative risk evaluation should be considered.