I know most of you are "youngsters" but as I come close to one year (Aug 5th) anniversary of my mitral valve repair (at age 75) the following article which just arrived in my email from Medscape is really of great interest to this "oldie". For those of you who are wondering if you are too old to undergo such a big procedure here is the good news--
Elderly Patients Benefit From Mitral Valve Surgery
NEW YORK (Reuters Health) Jul 17 - Surgery to correct mitral valve regurgitation is as effective in restoring life expectancy among elderly patients as it is in their younger counterparts, according to results of an outcomes study.
Dr. Maurice Enriquez-Sarano and his associates therefore recommend that mitral regurgitation surgery should be considered for elderly patients before refractory heart failure has developed.
"We want to dispel the message of gloom and doom that is given to older people," Dr. Enriquez-Sarano said in a press release.
Surgical techniques to repair or replace the mitral valve have improved significantly in recent years, but no studies have examined the effect of those improvements on elderly patients for whom such surgery had been considered too risky in the past, Dr. Enriquez-Sarano's team notes.
They therefore examined outcomes among the 1344 patients treated for isolated mitral regurgitation at the Mayo Clinic in Rochester, Minnesota, between 1980 and 1995.
According to the team's paper in the July 25th issue of Circulation released online July17, 556 (41%) patients were < 65 years old, 504 (38%) were between 65 and 74 years old, and 284 (21%) were 75 years of age and older.
Dr. Enriquez-Sarano and his colleagues report that 5-year survival was 57% for the oldest group, 73% for the middle group, and 85% for the youngest group -- "but ratios of observed to expected survival were similar (83%, 85% and 88%, respectively)."
The researchers note that, taking account of expected survival, "elderly patients showed no difference in life expectancy restoration compared with younger patients (adjusted hazard ratio, 0.89, p = 0.54)."
They also point out that all outcomes improved over time as surgeons gained experience with the procedures.
Overall, operative mortality decreased for all age groups, from 16% overall during the period 1980-1983, to 3% between 1992 and 1995. Corresponding trends were observed for low cardiac output following surgery, hospital length of stay, and increased feasibility of valve repair over valve replacement.
The investigators say that the current practice is to delay mitral regurgitation surgery among elderly patients until they have developed severe symptoms and atrial fibrillation. But based on their experiences, Dr. Enriquez-Sarano and his team recommend that "surgery should not be denied on the basis of age alone and, in carefully selected elderly patients, should be offered before the occurrence of refractory heart failure:"
Elderly Patients Benefit From Mitral Valve Surgery
NEW YORK (Reuters Health) Jul 17 - Surgery to correct mitral valve regurgitation is as effective in restoring life expectancy among elderly patients as it is in their younger counterparts, according to results of an outcomes study.
Dr. Maurice Enriquez-Sarano and his associates therefore recommend that mitral regurgitation surgery should be considered for elderly patients before refractory heart failure has developed.
"We want to dispel the message of gloom and doom that is given to older people," Dr. Enriquez-Sarano said in a press release.
Surgical techniques to repair or replace the mitral valve have improved significantly in recent years, but no studies have examined the effect of those improvements on elderly patients for whom such surgery had been considered too risky in the past, Dr. Enriquez-Sarano's team notes.
They therefore examined outcomes among the 1344 patients treated for isolated mitral regurgitation at the Mayo Clinic in Rochester, Minnesota, between 1980 and 1995.
According to the team's paper in the July 25th issue of Circulation released online July17, 556 (41%) patients were < 65 years old, 504 (38%) were between 65 and 74 years old, and 284 (21%) were 75 years of age and older.
Dr. Enriquez-Sarano and his colleagues report that 5-year survival was 57% for the oldest group, 73% for the middle group, and 85% for the youngest group -- "but ratios of observed to expected survival were similar (83%, 85% and 88%, respectively)."
The researchers note that, taking account of expected survival, "elderly patients showed no difference in life expectancy restoration compared with younger patients (adjusted hazard ratio, 0.89, p = 0.54)."
They also point out that all outcomes improved over time as surgeons gained experience with the procedures.
Overall, operative mortality decreased for all age groups, from 16% overall during the period 1980-1983, to 3% between 1992 and 1995. Corresponding trends were observed for low cardiac output following surgery, hospital length of stay, and increased feasibility of valve repair over valve replacement.
The investigators say that the current practice is to delay mitral regurgitation surgery among elderly patients until they have developed severe symptoms and atrial fibrillation. But based on their experiences, Dr. Enriquez-Sarano and his team recommend that "surgery should not be denied on the basis of age alone and, in carefully selected elderly patients, should be offered before the occurrence of refractory heart failure:"
