Key result
Urgent mitral valve surgery in patients ≥75 years had 6.9% in-hospital mortality versus 1.1% for elective surgery, with both groups achieving 77% cumulative 10-year survival.
Why the study?
Mitral valve surgery is increasingly offered to patients ≥ 75 years of age with severe mitral regurgitation or stenosis, but these patients have multiple comorbidities that may affect clinical outcomes.
What are the long-term survival outcomes of mitral valve surgery in patients ≥ 75 years of age?
Cohort (n=168)
No
What are the long-term survival outcomes of mitral valve surgery in patients ≥ 75 years of age?
Mitral valve surgery can be safely performed in patients ≥ 75 years of age, yielding excellent long-term outcomes with a 77% cumulative survival rate at 10 years.
Answers are grounded in this paper and cite their sources.
May inform shared decision-making in elderly mitral valve candidates; leaves open need for comparative trials before broader adoption.
Background There is an increasing trend to offer mitral valve surgery to patients ≥ 75 years of age for severe mitral regurgitation or stenosis. These patients have multiple comorbid conditions which may affect clinical outcomes. We present long‐term outcomes following mitral valve surgery in patients ≥ 75 years. Methods A prospective institutional study was performed. We analyzed data on patients ≥ 75 years who underwent mitral valve surgery from January 2013 to July 2023. Results 168 patients were included in the study with a mean age of 79 ± 1.2 years and a median EuroSCORE II of 4.7 and a median Logistic EuroSCORE of 11.02. The timing of surgery was urgent in 43.5% and elective in 56.5% of patients. There was no difference in preoperative variables between the urgent and elective groups. Infective endocarditis was present in 8% of urgent cases and 1% in elective patients. Mitral valve repair was performed in 46% of both groups, respectively, that is, urgent and elective groups. Tricuspid valve surgery was performed in 8.2% and 14.7% of patients, surgical ablation for atrial fibrillation in 4.1% and 10.5% of patients, and closure of left atrial appendage in 17.8% and 6.3% of patients, CABG in 38.4% and 32.6% of patients, and aortic valve replacement in 17.8% and 12.6% of patients. In‐hospital mortality was 6.9% in the urgent group and 1.1% in the elective group. Postoperative neurological changes were seen in 4% of elective patients and 1% in the urgent group, and there was no difference in the requirement of CVVH between the two groups. One‐ and five‐year survival rates are 92% and 84%, respectively, in the elective group and 88% and 77%, respectively, in the urgent group. Cumulative survival for both groups is 77% at 10 years. Conclusion Mitral valve surgery in association with concomitant valve or CABG operations can be safely performed in elderly patients with good early and late outcomes. Excellent 10‐year survival outcomes are seen with minimal attrition in those patients who have survived to 5 years.
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Barua et al. (2025) conducted a cohort in Severe mitral regurgitation or stenosis (n=168). Urgent mitral valve surgery vs. Elective mitral valve surgery was evaluated on In-hospital mortality. Urgent mitral valve surgery in patients ≥75 years had 6.9% in-hospital mortality versus 1.1% for elective surgery, with both groups achieving 77% cumulative 10-year survival.
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