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Ann Thorac Surg 2001;71:1752-1753
© 2001 The Society of Thoracic Surgeons

Correspondence

Mitral valve repair in the elderly

Victor Jebara, MDa

a Department of Cardiovascular and Thoracic Surgery, Saint-Joseph University, Hôtel-Dieu de France, Rue Adib - Ishak, Beirut, Lebanon

e-mail: uix{at}dm.net.lb

To the Editor

I read with interest the report by Grossi and colleagues [1] in which the authors report their results with mitral valve reconstruction in 278 patients operated on between 1980 and 1997. All patients were 70 years old or older (mean age 75.2 years). Isolated mitral valve repair was performed in 77 patients. The survival rate at 5 years was 72% and compared favorably with that in a matched control group from the general population. Freedom from reoperation at 5 years was 92.6% for isolated mitral valve repair and 91.8% for combined procedures.

The authors analyzed several studies discussing results of mitral valve replacement in the elderly population, but the only study they referred to that deals with mitral repair is one by Bolling and associates [2] concerning ischemic mitral regurgitation in patients older than 65 years. Therefore, what is remarkable in their report is that Grossi and colleagues made no allusion to previous work from Broussais Hospital by my co-workers and I [3], a study presented at the 64th annual meeting of the American Heart Association in 1991 and later published.

In this study, the hospital records of 79 consecutive patients older than 70 years (mean age, 74 years) who underwent mitral valve repair were reviewed. Results were comparable to those reported by Grossi and coauthors. Survival at 5 years was 81% and 97% of patients remained free from reoperation. In the majority of patients, a substantial improvement in New York Heart Association functional class was observed.

I congratulate the group from New York University Medical Center on their good study and excellent surgical results. However, I emphasize that their conclusions are identical to ours as reported in 1992 in embracing mitral valve repair as the treatment of choice for mitral regurgitation in elderly patients.

References

  1. Grossi E.A., Zakow P.K., Sussman M., et al. Late results of mitral valve reconstruction in the elderly. Ann Thorac Surg 2000;70:1224-1226.[Abstract/Free Full Text]
  2. Bolling S.F., Deeb G.M., Bach D.S. Mitral valve reconstruction in elderly, ischemic patients. Chest 1996;109:35-40.[Abstract/Free Full Text]
  3. Jebara V.A., Dervanian P., Acar C., et al. Mitral valve repair using Carpentier techniques in patients more than 70 years old. Early and late results. Circulation 1992;86(5 Suppl):II53-II59.



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