Transplant Medicine

Overview

Juan A. Crestanello, M.D., is a cardiovascular surgeon and department chair of Cardiovascular Surgery at Mayo Clinic in Rochester, Minnesota. Dr. Crestanello, who specializes in surgery for valvular heart disease, discusses clinical outcomes of mitral valve repair for degenerative mitral regurgitation in older patients.

JUAN A. CRESTANELLO: Welcome to the Cardiovascular Surgery Series, where we will review the latest research in cardiovascular surgery from the Mayo Clinic in just two minutes. I am Dr. Juan Crestanello. I am a cardiac surgeon at the Mayo Clinic in Rochester, Minnesota. We will discuss today the "Clinical outcomes of mitral valve repair for degenerative mitral regurgitation in elderly patients."

While mitral valve repair is the preferred treatment for patients with degenerative mitral valve regurgitation, it is unknown if that benefit holds true for elderly patients. Therefore, we review the outcomes of 345 patients older than 75 years of age who underwent mitral valve repair for degenerative mitral valve disease at our institution.

35% of the patients have associated procedures, including 20% who had associated tricuspid valve surgery. We found that mitral valve repair in the elderly is safe and durable. Safe because the operative mortality was only 1.2%, which is half of the predicted mortality. Durable because patients had a 97% freedom from reoperation at 10 years.

The long-term survival was at least the same, if not better than expected. We conclude that mitral valve repair in the elderly for degenerative mitral regurgitation is associated with excellent short- and long-term outcomes. It is durable and restores the patient's life expectancy. In addition, it allows for the performance of concomitant procedures that can further benefit the patients.

These results should be used as a standard against which new transcatheter procedures should be compared. Thank you for listening to the Mayo Clinic Cardiovascular Surgery Series.