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Thorac Cardiovasc Surg 2024; 72(08): 607-613
DOI: 10.1055/s-0043-1762940
Original Cardiovascular

Minimally Invasive Mitral Valve Surgery in the Elderly

Maximilian Franz
1   Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
,
Nunzio Davide De Manna
2   Division of Cardiac Surgery, Cardiothoracic Department, University Hospital, Udine, Italy
,
Saskia Schulz
1   Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
,
Fabio Ius
1   Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
,
Axel Haverich
1   Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
,
Serghei Cebotari
1   Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
,
Igor Tudorache
3   Department of Cardiac Surgery, University Hospital Düsseldorf, Düsseldorf, Germany
,
Jawad Salman
1   Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
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Abstract

Background The minimally invasive mitral valve procedure warrants minimal surgical trauma and might influence the postoperative course positively, especially in old patients. In this retrospective study, we reviewed our experience in minimally invasive mitral valve surgery (miMVS) in patients aged ≥ 75 years.

Methods In this retrospective cohort study, based on propensity score matching, we compared patients aged ≥75 years with patients aged <75 years who underwent miMVS. The primary endpoint was 30-day mortality. Secondary endpoints were myocardial infarction, stroke, and renal failure.

Results Between January 2011 and February 2021, 761 patients underwent miMVS at our institution. After propensity score matching, a study group (≥75 years, n = 189) and a control group (<75 years, n = 189) were formed. Preoperatively patients ≥75 years more often suffered from NYHA III heart failure (60 vs. 46%; p = 0.013). Their valves were more often frequently replaced (48 vs. 32%; p < 0.001), and their postoperative ventilation time was longer (13 hours vs. 11 hours; p < 0.001). There were no statistically significant differences regarding postoperative stroke (3 vs. 0.6%; p = 0.16), myocardial infarction (0 vs. 1%; p = 0.32), renal insufficiency with new dialysis (5 vs. 4%; p = 0.62), and 30-day mortality (4 vs. 2%; p = 0.56).

Conclusion miMVS results in satisfactory early postoperative outcomes in elderly patients.

Keywords

mitral valve surgery - outcomes - risk factors


Publication History

Received: 03 July 2022

Accepted: 10 January 2023

Article published online:
01 March 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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