Navigate Up

UPMC/University of Pittsburgh Schools of the Health Sciences
For Journalists
Manager
Telephone: 412-647-9966
Director
Telephone: 412-417-2582
Other Inquiries

UPMC and University of Pittsburgh

Surgery for Common Heart Valve Condition in Elderly is Safe, Restores Longevity

PITTSBURGH, Jan. 30, 2012 – Mitral valve repair in the elderly is safe and should be considered not as a last resort but as a treatment option for patients over 65 suffering from mitral regurgitation, according to findings of a large, multicenter study that analyzed more than 14,000 valve repair operations among this age group.

Mitral regurgitation, or a leaking mitral valve in the heart, can significantly limit long-term life expectancy and reduce quality of life due to its secondary effects. Young patients suffering from mitral regurgitation have their valves repaired as a first course of treatment. However, current treatment guidelines in elderly patients call for medical treatments to be tried first because advanced age was believed to put these patients at high risk for complications and little was known about their long-term outcomes. Mitral valve repair often was only done in the elderly once symptoms worsened.

“We found that mitral repair in older individuals is well tolerated, with low mortality, low morbidity and that reoperations are uncommon. Most importantly, following mitral repair, patient’s 10-year survival is restored to the normal matched U.S. population,” said Vinay Badhwar, M.D., co-director, UPMC Center for Mitral Valve Disease, the study’s lead author. He presented the findings at the opening of the Annual Meeting of The Society of Thoracic Surgeons in Fort Lauderdale, Fla., on January 30 as the J. Maxwell Chamberlain Memorial Paper for Adult Cardiac Surgery.

Researchers in the study analyzed clinical data from The Society of Thoracic Surgeons Adult Cardiac Surgery Database matched to longitudinal claims data from the Centers for Medicare and Medicaid Services and identified 14,604 isolated non-emergent primary mitral valve repair operations between 1991 and 2007. The cases were studied for mortality, mitral reoperation and readmissions for heart failure, bleeding and stroke.

The number of patients who died during or soon after surgery was only 2.6 percent and that survival during follow-up was 74 percent. Also, the 10-year actuarial survival was restored to the normal matched U.S. population, Dr. Badhwar said. After adjusting for the statistical impact of late mortality, the researchers found that mitral repair was durable, with reoperation occurring in only 5 percent of cases.

“The results indicate that age alone should not be a marker of high risk in isolated mitral valve disease and that there should be some careful thought given when medical therapy is considered over mitral repair in older patients,” said Dr. Badhwar, also co-director of the UPMC Center for Atrial Fibrillation and associate professor of Surgery in the Department of Cardiothoracic Surgery at the University of Pittsburgh School of Medicine. “Based on these data, guideline recommendations for medical therapy for symptomatic mitral regurgitation based on age alone should be re-evaluated.”

Collaborators on the study were Eric D. Peterson, M.D.; Xia He, M.Sc.; J. Matthew Brennan, M.D.; Sean M. O’Brien, Ph.D.; and Rachel S. Dokholyan, M.P.H., all of the Duke Clinical Research Institute; Jeffrey P. Jacobs, M.D., of The  Congenital Heart Institute of Florida, All Children’s Hospital, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida; Steven F. Bolling, M.D., University of Michigan;  David M. Shahian, M.D., Massachusetts General Hospital; Fredrick L. Grover, M.D., University of Colorado;  Fred H. Edwards, M.D., University of Florida; and James S. Gammie, M.D., University of Maryland.

The study was supported by The Society of Thoracic Surgeons Research Center through the Adult National Cardiac Database and the Duke Clinical Research Institute.

©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com