Surgical Treatment of Degenerative Mitral Valve Regurgitation in the Elderly: Comparison of Early and Long-Term Outcomes Using Propensity Score Matching Analysis.
10.5090/kjtcs.2018.51.6.367
- Author:
Joon Seok LEE
1
;
Kyung Hwan KIM
;
Jae Woong CHOI
;
Ho Young HWANG
;
Ki Bong KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Korea. kkh726@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Mitral valve insufficiency;
Mitral valve annuloplsty;
Heart valve prosthesis implantation;
Aged
- MeSH:
Aged*;
Cohort Studies;
Freedom;
Heart Valve Prosthesis Implantation;
Humans;
Mitral Valve Insufficiency*;
Mitral Valve*;
Mortality;
Propensity Score*;
Reoperation;
Risk Factors
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2018;51(6):367-375
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: It is unclear whether mitral valve (MV) repair for degenerative mitral regurgitation (MR) provides the same advantages in the elderly that it does in the general population. METHODS: From 1994 to 2016, 188 elderly patients (mean age, 68.3±5.50 years) underwent MV repair (n=153) or MV replacement (n=35) for primary degenerative MR. Early and long-term outcomes were compared before and after propensity score matching (PSM). RESULTS: Before PSM, there was a significant difference in operative mortality (p=0.011). Overall survival and freedom from cardiac-related death (CRD) at 5, 10, and 15 years were significantly higher in patients who underwent MV repair (p=0.039 and p=0.007, respectively). In the multivariable analysis, MV replacement was an independent risk factor of CRD. After PSM, operative mortality was not significantly lower in patients who underwent MV repair (p=0.125). Overall survival and freedom from CRD at 5, 10, and 15 years showed no significant difference between the 2 groups in the PSM cohort (p=0.207, p=0.47, respectively). There was no significant difference in freedom from reoperation before or after PSM (p=0.963 and p=0.575, respectively). CONCLUSION: MV repair for primary degenerative MR might be a valid option in the elderly population if successful repair is possible.
