Open Access
Thorac Cardiovasc Surg 2018; 66(S 01): S1-S110
DOI: 10.1055/s-0038-1627899
Oral Presentations
Sunday, February 18, 2018
DGTHG: Valvular Heart Disease: AV-Valves I
Georg Thieme Verlag KG Stuttgart · New York

Midterm Outcomes after Minimally Invasive Mitral Valve Surgery through a Right Anterior Minithoracotomy over 75 Years of Age

Authors

  • M. Van Hemelrijck

    1   Department of Cardiovascular Surgery, Universitätsspital Zürich, Zürich, Switzerland

  • D. Reser

    1   Department of Cardiovascular Surgery, Universitätsspital Zürich, Zürich, Switzerland

  • F. Maisano

    1   Department of Cardiovascular Surgery, Universitätsspital Zürich, Zürich, Switzerland

  • C. A. Mestres

    1   Department of Cardiovascular Surgery, Universitätsspital Zürich, Zürich, Switzerland

  • B. Seifert

    2   Department of Epidemiology, Biostatistics and Prevention Institute, Universität Zürich, Zürich, Switzerland

  • V. Falk

    3   Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany

  • A. Weber

    1   Department of Cardiovascular Surgery, Universitätsspital Zürich, Zürich, Switzerland
Further Information

Publication History

Publication Date:
22 January 2018 (online)

 
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Objectives: In this single center study we aim to report outcomes after minimally invasive mitral valve surgery in patients older than 75 years of age.

Methods: Retrospective analysis of patients 75 years or older who underwent minimal invasive mitral valve surgery through a right anterior mini-thoracotomy between 2009 and 2014.

Results: 75 patients were identified. Mean age was 79.2 ± 3.1 years and 48% were men. Degenerative mitral regurgitation was the most frequent underlying etiology (44%). Mean EuroSCORE was 7.3 (range 2–13). Mean preoperative left ventricular ejection fraction (EF) was 60.5% ± 10.4. Isolated mitral surgery was performed in 51%. In 78% (59 patients) mitral repair was achieved. There were no in-hospital deaths. Median follow-up was 36 months and 2 (2.7%) patients were lost to follow-up. Overall mortality was 20% and four (5.3%) patients died from cardiac reasons. Survival at 12 and 40 months was 93.4% and 80%, respectively. One patient (1.3%) required mitral valve replacement 10 months after surgery. Major adverse cardiac and cerebrovascular events (MACCE) occurred in 2.7% (2 patients). At echocardiographic follow up 87% (46/53) of the mitral repairs remained stable (MR≤2+). 94% of all patients remained asymptomatic (NYHA≤2).

Conclusion: Minimally invasive mitral valve surgery through a right anterior mini-thoracotomy in elderly patients over 75 years of age is safe and offers stable mid-term results. High repair rates combined with high freedom of MACCE and reoperation is feasible with minimal invasive mitral valve surgery in this elderly population.


No conflict of interest has been declared by the author(s).

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