P688Degenerative mitral regurgitation valve repair in elderly patients


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Abstract

Objectives: To describe the results and evolution of mitral valve repair in elderly patients, and compare them with those of a younger population.Methods: 128 patients with degenerative mitral regurgitation (MR) due to mitral valve prolapse involving 1-2 segments underwent mitral valve repair in the period 2001-2010: group A (> 75 years) 36 patients; group B (< 75 years) 92 patients. We compared the clinical and echocardiographic outcomes right after surgery, and annually afterwards. Results: Elderly patients undergo mitral valve repair when they are more symptomatic (NYHA-FC III-IV before surgery: group A 88%, group B 71%; p=0.06); and have a higher Euroscore (group A 9.8, group B 3; p<0.0005). We didn't find differences between both groups about basal echocardiographic measurements (LVEDD, LVEF, degree of MR, PAP, anterior/posterior leaflet affectation). Neochordaes were more often used in younger patients (group A 10%, group B 30%; p <0,02), without discovering other differences in surgical techniques. In-hospital mortality is higher in elderly patients (group A 11%, group B 1%; p<0.008). During follow-up, (group A median follow up is 31 months, group B 45 months) there weren't any differences in the reintervention rate, the degree of mitral regurgitation or any other echocardiographic findings, except pulmonary hypertension (group A 40 mmHg, group B 33 mmHg; p<0.005). All the patients in both groups are in NYHA-FC I-II. Conclusions: Elderly patients undergo mitral valve repair surgery when they are more symptomaptic, with a higher Euroscore value, and present higher in-hospital mortality. However, during follow-up they have the same clinical and echocardiographic outcomes than younger patients.

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