Surgical treatment of degenerative mitral valve regurgitation in the elderly

Comparison of early and long-term outcomes using propensity score matching analysis

Research output: Contribution to journalArticleResearchpeer-review

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.

Original languageEnglish
Pages (from-to)367-375
Number of pages9
JournalKorean Journal of Thoracic and Cardiovascular Surgery
Volume51
Issue number6
DOIs
StatePublished - 1 Jan 2018

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Propensity Score
Mitral Valve Insufficiency
Mitral Valve
Therapeutics
Survival
Mortality
Reoperation
Population

Keywords

  • Aged
  • Heart valve prosthesis implantation
  • Mitral valve annuloplsty
  • Mitral valve insufficiency

Cite this

@article{cfa983b2e74946dd976e54a569603fe5,
title = "Surgical treatment of degenerative mitral valve regurgitation in the elderly: Comparison of early and long-term outcomes using propensity score matching analysis",
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.",
keywords = "Aged, Heart valve prosthesis implantation, Mitral valve annuloplsty, Mitral valve insufficiency",
author = "Lee, {Joon Seok} and Kim, {Kyung Hwan} and Choi, {Jae Woong} and Hwang, {Ho Young} and Ki-Bong Kim",
year = "2018",
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doi = "10.5090/kjtcs.2018.51.6.367",
language = "English",
volume = "51",
pages = "367--375",
journal = "Korean Journal of Thoracic and Cardiovascular Surgery",
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publisher = "Korean Society for Thoracic and Cardiovascular Surgery",
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TY - JOUR

T1 - Surgical treatment of degenerative mitral valve regurgitation in the elderly

T2 - Comparison of early and long-term outcomes using propensity score matching analysis

AU - Lee, Joon Seok

AU - Kim, Kyung Hwan

AU - Choi, Jae Woong

AU - Hwang, Ho Young

AU - Kim, Ki-Bong

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

KW - Aged

KW - Heart valve prosthesis implantation

KW - Mitral valve annuloplsty

KW - Mitral valve insufficiency

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JF - Korean Journal of Thoracic and Cardiovascular Surgery

SN - 2233-601X

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