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- Title
Benefits of mitral valve repair over replacement in the elderly: a systematic review and meta-analysis.
- Authors
Di Tommaso, Ettorino; Rapetto, Filippo; Guida, Gustavo A.; Zakkar, Mustafa; Bruno, Vito D.
- Abstract
<bold>Objectives: </bold>Mitral valve (MV) repair has demonstrated excellent short- and long-term outcomes, however, its merit in the elderly population is still debated. We conducted a meta-analysis of studies that have compared the MV repair to replacement in the elderly population.<bold>Methods: </bold>A systematic literature search was conducted for any study published on MV surgery on elderly patients (≥75 years old). A pooled risk-ratio meta-analysis was done to evaluate short-term mortality, postoperative complications, surgical timings, and long-term survival rates.<bold>Results: </bold>A total of nine retrospective observational studies were included in the quantitative meta-analysis. Pooled meta-analysis showed a reduced risk of short-term mortality for the MV repair group (risk ratio [RR] = 0.41 [0.24-0.71], p-value = .005). Postoperative neurological complications were in favor of repair, although not significantly (RR = 0.49 [0.21-1.11], p-value = .07). Operative timings (cardiopulmonary bypass and crossclamp time) were not different between the groups although no data were available on the complexity of the repairs. Long-term survival rates were in favor of the repairs (pooled treatment effect of -0.47 [-0.64; -0.29], p = .005).<bold>Conclusions: </bold>MV surgery is a safe and effective procedure for the elderly. MV repair demonstrated better short-term outcomes compared to replacement. Long-term survival rates are significantly better after repair.
- Subjects
MITRAL valve; SURVIVAL rate; OLDER people; OLDER patients; SURGICAL complications; MITRAL valve surgery; MITRAL valve insufficiency; META-analysis; SYSTEMATIC reviews; RETROSPECTIVE studies; TREATMENT effectiveness; PROSTHETIC heart valves
- Publication
Journal of Cardiac Surgery, 2021, Vol 36, Issue 7, p2524
- ISSN
0886-0440
- Publication type
journal article
- DOI
10.1111/jocs.15506