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Mitral Valve Repair Improves Survival in the Elderly

July 21, 2006 -  Researchers studied records of 10 years
of mitral valve (MV) repair versus MV replacement in
the elderly. Reasons for the surgeries was floppy mitral
valves/mitral valveprolapse (FMV/MVP).
	292 consecutive patients at least 70 years old
having mitral valve surgery for regurgitation due to
FMV/MVP were reviewed from a database between
January 1 of 1992 and December 31 of 2002. Those
also having bypass surgery (CABG) were included.
	218 patients had valve repairs and 74 had
valve replacements. Average follow-up was 6 years for
MV repair and 7 years for MV replacement.
	Patients having just MV repair had lower
risk of in-hospital death (0.7%) and shorter hospital
stay (9 days) than those having MV replacement
(13.9% mortality and 10 day stay).
	Patients with MV repair had lower risk of
death for the 5-year period after surgery (81% survival)
than those with MV replacement (63% survival).
	Only 6% of valve repair patients needed
another "valve job" while 2% of valve replacement
patients needed one.

Researchers conclude that in elderly patients, MV repair
reduces in-hospital mortality and length of stay, and
increases long-term survival. The preferred option for
elderly patients with FMV/MVP should be MV repair.

Title:       Operative and long-term survival of elderly is
               significantly improved by mitral valve repair.
Authors: Andrew Gogbashian, Jerome Sepic, Edward
               Soltesz, Lugino Nascimben, Lawrence Cohn.
Source:    Am Heart J 2006;151:1325-1333.