PMID- 32998167
OWN - NLM
STAT- MEDLINE
DCOM- 20220321
LR  - 20220321
IS  - 1439-1902 (Electronic)
IS  - 0171-6425 (Linking)
VI  - 70
IP  - 2
DP  - 2022 Mar
TI  - Long-Term Clinical Outcome in Elderly Patients Undergoing Mitral Valve Repair.
PG  - 93-99
LID - 10.1055/s-0040-1716324 [doi]
AB  - BACKGROUND:  Long-term data on patients over 75 years undergoing mitral valve 
      (MV) repair are scarce. At our high-volume institution, we, therefore, aimed to 
      evaluate mortality, stroke risk, and reoperation rates in these patients. 
      METHODS:  We investigated clinical outcomes in 372 patients undergoing MV repair 
      with (n = 115) or without (n = 257) tricuspid valve repair. The primary endpoint 
      was the probability of survival up to a maximum follow-up of 9 years. Secondary 
      clinical endpoints were stroke and reoperation of the MV during follow-up. 
      Univariate and multivariable Cox regression analysis was performed to assess 
      independent predictors of mortality. Mortality was also compared with the age- 
      and sex-adjusted general population. RESULTS:  During a median follow-up period 
      of 37 months (range: 0.1-108 months), 90 patients died. The following parameters 
      were independently associated with mortality: double valve repair (hazard ratio, 
      confidence interval [HR, 95% CI]: 2.15, 1.37-3.36), advanced age (HR: 1.07, CI: 
      1.01-1.14 per year), diabetes (HR: 1.97, CI: 1.13-3.43), preoperative New York 
      Heart Association (NYHA) functional class (HR: 1.41, CI: 1.01-1.97 per class), 
      and operative creatinine(max) levels (HR: 1.32, CI: 1.13-1.55 per mg/dL). The 
      risk of stroke in the isolated MV and double valve repair groups at postoperative 
      year 5 was 5.0 and 4.1%, respectively (p = 0.65). The corresponding values for 
      the risk of reoperation were 4.0 and 7.0%, respectively (p = 0.36). Nine-year 
      survival was comparable with the general population (53.2 vs. 53.1%). CONCLUSION: 
       Various independent risk factors for mortality in elderly MV repair patients 
      could be identified, but overall survival rates were similar to those of the 
      general population. Consequently, our data indicates that repairing the MV in 
      elderly patients represents a suitable and safe surgical approach.
CI  - Thieme. All rights reserved.
FAU - Gotte, Julia
AU  - Gotte J
AD  - Department of Cardio-Thoracic Surgery, Heart and Diabetes Center North Rhine 
      Westphalia, Bad Oeynhausen, Nordrhein-Westfalen, 32545, Germany.
FAU - Zittermann, Armin
AU  - Zittermann A
AD  - Department of Cardio-Thoracic Surgery, Heart and Diabetes Center North Rhine 
      Westphalia, Bad Oeynhausen, Nordrhein-Westfalen, 32545, Germany.
FAU - Hakim-Meibodi, Kavous
AU  - Hakim-Meibodi K
AD  - Department of Cardio-Thoracic Surgery, Heart and Diabetes Center North Rhine 
      Westphalia, Bad Oeynhausen, Nordrhein-Westfalen, 32545, Germany.
FAU - Hata, Masatoshi
AU  - Hata M
AD  - Department of Cardio-Thoracic Surgery, Heart and Diabetes Center North Rhine 
      Westphalia, Bad Oeynhausen, Nordrhein-Westfalen, 32545, Germany.
FAU - Schramm, Rene
AU  - Schramm R
AD  - Department of Cardio-Thoracic Surgery, Heart and Diabetes Center North Rhine 
      Westphalia, Bad Oeynhausen, Nordrhein-Westfalen, 32545, Germany.
FAU - Bleiziffer, Sabine
AU  - Bleiziffer S
AD  - Department of Cardio-Thoracic Surgery, Heart and Diabetes Center North Rhine 
      Westphalia, Bad Oeynhausen, Nordrhein-Westfalen, 32545, Germany.
FAU - Parsa, Mohammed Amin
AU  - Parsa MA
AD  - Department of Cardio-Thoracic Surgery, Heart and Diabetes Center North Rhine 
      Westphalia, Bad Oeynhausen, Nordrhein-Westfalen, 32545, Germany.
FAU - Gummert, Jan
AU  - Gummert J
AD  - Department of Cardio-Thoracic Surgery, Heart and Diabetes Center North Rhine 
      Westphalia, Bad Oeynhausen, Nordrhein-Westfalen, 32545, Germany.
FAU - Renner, Andre
AU  - Renner A
AD  - Department of Cardio-Thoracic Surgery, Heart and Diabetes Center North Rhine 
      Westphalia, Bad Oeynhausen, Nordrhein-Westfalen, 32545, Germany.
LA  - eng
PT  - Journal Article
DEP - 20200930
PL  - Germany
TA  - Thorac Cardiovasc Surg
JT  - The Thoracic and cardiovascular surgeon
JID - 7903387
SB  - IM
MH  - Aged
MH  - *Cardiac Surgical Procedures/adverse effects
MH  - *Heart Valve Prosthesis Implantation/adverse effects
MH  - Humans
MH  - Mitral Valve/diagnostic imaging/surgery
MH  - *Mitral Valve Insufficiency/diagnostic imaging/surgery
MH  - Reoperation
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
COIS- None declared.
EDAT- 2020/10/01 06:00
MHDA- 2022/03/22 06:00
CRDT- 2020/09/30 20:07
PHST- 2020/10/01 06:00 [pubmed]
PHST- 2022/03/22 06:00 [medline]
PHST- 2020/09/30 20:07 [entrez]
AID - 10.1055/s-0040-1716324 [doi]
PST - ppublish
SO  - Thorac Cardiovasc Surg. 2022 Mar;70(2):93-99. doi: 10.1055/s-0040-1716324. Epub 
      2020 Sep 30.