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KMID : 0364020180510060367
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Korean Journal of Thoracic and Cardiovascular Surgery
2018 Volume.51 No. 6 p.367 ~ p.375
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Surgical Treatment of Degenerative Mitral Valve Regurgitation in the Elderly: Comparison of Early and Long-Term Outcomes Using Propensity Score Matching Analysis
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Lee Joon-Seok
Kim Kyung-Hwan
Choi Jae-Woong
Hwang Ho-Young
Kim Ki-Bong
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Abstract
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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.
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KEYWORD
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Mitral valve insufficiency, Mitral valve annuloplsty, Heart valve prosthesis implantation, Aged
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