title: Feasibility and efficacy of mitral valve repair for degenerative mitral regurgitation in the elderly.
abstract: OBJECTIVE
  The number of elderly patients who require surgical treatment for mitral regurgitation (MR) is increasing. However, the feasibility and efficacy of mitral valve repair in elderly patients are unclear.
  
  
  METHODS
  We retrospectively reviewed 55 patients, aged ≥75 years, who underwent mitral valve repair for degenerative MR between 1991 and 2011. All patients were followed up for 4.7 ± 3.4 years.
  
  
  RESULTS
  The patients aged ≥75 years were more symptomatic and had a higher incidence of persistent atrial fibrillation and pulmonary hypertension than those aged &lt;75 years. Thirty-day and in-hospital mortality was 1.8% and 7.3%, respectively, and the 5-year survival rate was 81.6% ± 5.8%. The leading cause of late death was stroke, which primarily occurred in patients with postoperative atrial fibrillation. Except for a single failure of repair due to technical reasons, there was no recurrence of severe MR or reoperation on the mitral valve. In the late follow-up period, the mean left ventricular diastolic diameter significantly decreased and the mean left ventricular ejection fraction was approximately 60%. Most patients had mild symptoms at follow-up.
  
  
  CONCLUSIONS
  Mitral valve repair can provide satisfactory early as well as long-term outcomes and can preserve left ventricular function even in the elderly.
authors.affiliation: Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Murashita
authors.forename: Yukikatsu
authors.initials: Y
authors.lastname: Okada
authors.forename: Hideo
authors.initials: H
authors.lastname: Kanemitsu
authors.forename: Naoto
authors.initials: N
authors.lastname: Fukunaga
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Konishi
authors.forename: Ken
authors.initials: K
authors.lastname: Nakamura
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Koyama
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery*; D058386:Mitral Valve Annuloplasty / Q000009:adverse effects / Q000401:mortality; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left