European Journal of Cardio-Thoracic Surgery, Vol 8, 298-300, Copyright © 1994 by European Association for Cardio-thoracic Surgery
Mitral valve repair in patients over the age of 70 years
H Azar and S Szentpetery
Sentara Norfolk General Hospital, Virginia.
The question of whether to repair or replace the mitral valve in the
elderly remains unanswered. The purpose of our study is to describe our
experience with mitral valve repair (MVR) using Carpentier's technique in
patients 70 years and older. Fifty consecutive patients underwent MVR
between 1984-1992. There were 30 female patients. All had 2 + or more
mitral regurgitation (MR). The valve pathology included ischemic (n = 28),
myxomatous (n = 7) and rheumatic (n = 6), leaflet prolapse (n = 11) and
healed bacterial endocarditis (n = 3). The clinical findings included:
myocardial infarction (n = 17), congestive heart failure (n = 18), atrial
fibrillation (n = 14) and pulmonary hypertension (n = 10). The surgical
technique involved placement of a Carpentier ring (n = 41) or Duran ring (n
= 3), resection of leaflets (n = 9), shortening of the chordae (n = 8) and
commissurotomy (n = 6). At surgery, coronary bypass was carried out in 32
patients while the aortic valve was replaced in five and repaired in one.
Postoperative complications included atrial fibrillation (n = 14),
transient neurologic events (n = 4), heart block requiring pacemaker (n =
3) and prolonged intubation (n = 4). Echocardiogram carried out
postoperatively showed 2 + MR in three patients, 1 + in four, and a trace
or none in the remaining (n = 39). No patient required re-operation for MR.
Three patients (6%) died within 30 days after surgery due to low output (n
= 1), malignant ventricular arrhythmia (n = 1) and heart block with cardiac
arrest (n = 1).(ABSTRACT TRUNCATED AT 250 WORDS)
