title: Mitral valve surgical procedures in the elderly.
abstract: BACKGROUND
  Mitral valve (MV) surgical procedures in the elderly are associated with profound operative and long-term mortality. We report our experience and results for MV surgical procedures in the elderly, especially with regard to the influence of comorbidities.
  
  
  METHODS
  Our hospital database was assessed to identify all patients who underwent MV surgical procedures at the age of 70 years and older between 1999 and 2009. The data were retrospectively analyzed.
  
  
  RESULTS
  A total of 2,503 patients operated on during this 10-year period were identified. In 97% of patients, mitral regurgitation (MR) was the primary indication for operation, followed by coronary artery disease in 41.6% and aortic valve stenosis in 21.3%. The 30-day mortality rate was 3.1%, and the long-term survival at 5 years was 55.2% (95% confidence interval, 52.3% to 57.5%). Coronary artery bypass grafting was identified to be associated with inferior short-term and long-term survival. Numerous comorbidities significantly influenced long-term survival. The observed mortality was significantly lower than predicted by EuroSCORE (17.2%).
  
  
  CONCLUSIONS
  MV operations in the elderly can be performed with a low early mortality and promising long-term survival. However, our large series demonstrates that comorbidities are to be attributed as the real burden for successful treatment of elderly patients undergoing MV procedures.
authors: Department of Cardiac Surgery, University Heart Center Leipzig, Germany. seej@med.uni-leipzig.de
authors: Joerg
authors: J
authors: Seeburger
authors: Volkmar
authors: V
authors: Falk
authors: Jens
authors: J
authors: Garbade
authors: Thilo
authors: T
authors: Noack
authors: Philipp
authors: P
authors: Kiefer
authors: Marcel
authors: M
authors: Vollroth
authors: Friedrich W
authors: FW
authors: Mohr
authors: Martin
authors: M
authors: Misfeld
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods* / Q000401:mortality; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000401:mortality / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013557:Switzerland / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome