Surgical Treatment of Degenerative Mitral Valve Regurgitation in the Elderly: Comparison of Early and Long-Term Outcomes Using Propensity Score Matching Analysis.

Abstract

BackgroundIt 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.MethodsFrom 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).ResultsBefore 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).ConclusionMV repair for primary degenerative MR might be a valid option in the elderly population if successful repair is possible.