Korean Journal of Thoracic and Cardiovascular Surgery 2018; 51(6): 367-375  https://doi.org/10.5090/kjtcs.2018.51.6.367
Surgical Treatment of Degenerative Mitral Valve Regurgitation in the Elderly: Comparison of Early and Long-Term Outcomes Using Propensity Score Matching Analysis
Joon Seok Lee, M.D., Kyung Hwan Kim, M.D., Ph.D., Jae Woong Choi, M.D., Ho Young Hwang, M.D., Ph.D., and Ki-Bong Kim, M.D., Ph.D.
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine
Corresponding author: Kyung Hwan Kim, Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea

(Tel) 82-2-2072-3971 (Fax) 82-2-764-3664 (E-mail) kkh726@snu.ac.kr
Received: July 16, 2018; Revised: October 1, 2018; Accepted: October 1, 2018.; Published online: December 5, 2018.
© The Korean Journal of Thoracic and Cardiovascular Surgery. All rights reserved.

cc This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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: Mitral valve insufficiency, Mitral valve annuloplsty, Heart valve prosthesis implantation, Aged


This Article


Cited By Articles
  • CrossRef (0)

Services
Social Network Service

Archives