Quality of life of elderly patients following valve surgery for chronic organic mitral regurgitation☆

Maisano, Francesco; Viganò, Giorgio; Calabrese, Chiara; Taramasso, Maurizio; Denti, Paolo; Blasio, Andrea Di; Guidotti, Andrea; Alfieri, Ottavio

doi:10.1016/j.ejcts.2009.02.055

Cited by 29 publications

(7 citation statements)

References 14 publications

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“…This effect was observed on top of optimal medical therapy and in highly symptomatic patients: as opposed to EVEREST II, with 49% of patients in NYHA functional class I or II, we included only patients in NYHA functional class III or IV. Also, MLHFQ score improved by almost 20 points, which is comparable with results reported for MV surgery (7). In accordance, 6-min walk distance increased in 75% of our patients, further underscoring the profound clinical benefit derived from this therapy in the majority of patients included.…”

supporting

confidence: 92%

Echocardiographic and Clinical Outcomes of MitraClip Therapy in Patients Not Amenable to Surgery

Rudolph

Knap

Franzen

et al. 2011

Journal of the American College of Cardiology

131

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supporting

confidence: 92%

Echocardiographic and Clinical Outcomes of MitraClip Therapy in Patients Not Amenable to Surgery

Rudolph

Knap

Franzen

et al. 2011

Journal of the American College of Cardiology

131

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“…Immer et al [24], on the contrary, using SF-36 questionnaire, did not find any difference between QoL after mitral valve replacement or repair in a series of 115 patients at 3 years after surgery, although inhospital mortality was significant higher in replacement than in repair patients. Also Maisano et al [25] concluded that the type of surgical technique does not influence QoL at follow-up, but perceived selfhealth is worse in patients with recurrent/residual MR following repair.…”

Section: Discussionmentioning

confidence: 98%

Quality of life following percutaneous mitral valve repair with the MitraClip System

Ussia

Sarkar

Scandura

et al. 2012

International Journal of Cardiology

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“…Though operative risks of mitral valve surgery reduced significantly during the last decades [20], however quality of life after such surgical interventions, a factor of great importance in the elderly population has rarely been reported. Maissano et al [21] found that quality of life was suboptimal in more than half of elderly patients following mitral valve surgery and that surgical technique did not impact quality of life at follow up. They identified several factors significantly related to increased Minnesota Living With Heart Failure (MLHF) - score at follow-up after valve surgery in the elderly.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of conventional surgery versus MitraClip® therapy for moderate to severe symptomatic mitral valve regurgitation in the elderly population: an institutional experience

Alozie

Paranskaya

Westphal

et al. 2017

BMC Cardiovasc Disord

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BackgroundThe aim of this study was to compare treatment of moderate to severe symptomatic mitral regurgitation (MR) with either conventional surgery or the mitral valve edge-to-edge device (MitraClip®) in very elderly patients. The newly introduced MitraClip device has demonstrated promising acute results in treating this patient cohort. Also noteworthy is the fact that patients who otherwise would have been denied surgery are increasingly referred for treatment with the MitraClip device. We sought to review our institutional experience, comparing outcomes in both surgical and MitraClip arms of treatment in the elderly population with symptomatic MR.MethodsFrom October 2008 through October 2014, 136 consecutive patients aged ≥ 80 with moderate to severe symptomatic MR were scheduled for either conventional surgery or MitraClip intervention. 56 patients ≥ 80 were operated for symptomatic MR and 80 patients ≥ 80 were treated with the mitraClip device. Patients suitable for this study were identified from our hospital database. Patients ≥80 with moderate/severe symptomatic MR treated with either conventional surgery or the MitraClip device were eligible for our analysis. We compared the surgical patient cohort with the mitraClip patient cohort after eliminating patients that did not meet our inclusion criteria. Forty-two patients were identified from the conventional cohort who were then compared with 42 patients from the mitraClip cohort. Forty-two patients (50%) underwent mitral valve repair or replacement (40.5% functional MR, 59.5% organic/mixed MR) and 42 patients (50%) underwent MitraClip intervention (50% functional MR, 50% organic/mixed MR). Associated procedures in the conventional surgical group were myocardial revascularization 38%, pulmonary vein ablation 23.8%, left atrial appendage resection 52.4% and PFO occlusion 11.9%.ResultsPatients who underwent MitraClip treatment were though slightly older but the differences did not attain statistical significance (mean, 82.2 ± 1.65 vs 81.7 ± 1.35 years, p = 0,100), had lower LVEF (mean, 47.6 ± 14.2 vs 53.4 ± 14.3, p = 0.072), lower logistic EuroScore II (mean, 11.3 ± 5.63 vs 12.1 ± 10.6, p = 0.655) but higher STS risk score (mean, 11.8 ± 6.7 vs 8.1 ± 5.6, p = 0.008) respectively compared to surgical patients. Procedural success was 100% vs 96% in surgery and MitraClip groups respectively. Thirty -day mortality was 7.1% vs 4.8% (p = 1.000) in surgery and MitraClip group respectively. Residual postoperative MR ≥2 at discharge was present in none of the patients treated surgically, whereas this was the case in 10 (23.8%) patients treated with the MitraClip device. At 1 year a cumulative number of four (9.52%) patients died in the surgical group vs 9 (21.4%) patients who died in the MitraClip group.ConclusionsElderly patients presenting with moderate to severe symptomatic MR may either be treated by conventional surgery or with the MitraClip device with acceptable acute outcomes. The decision for treatment with the MitraClip device should not depend on age alone ...

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Quality of life of elderly patients following valve surgery for chronic organic mitral regurgitation☆

Cited by 29 publications

References 14 publications

Echocardiographic and Clinical Outcomes of MitraClip Therapy in Patients Not Amenable to Surgery

Echocardiographic and Clinical Outcomes of MitraClip Therapy in Patients Not Amenable to Surgery

Quality of life following percutaneous mitral valve repair with the MitraClip System

Clinical outcomes of conventional surgery versus MitraClip® therapy for moderate to severe symptomatic mitral valve regurgitation in the elderly population: an institutional experience

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