{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T23:56:18Z","timestamp":1782345378095,"version":"3.54.5"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T00:00:00Z","timestamp":1652054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>This study analyzes the safety and outcomes of mitral valve repair for degenerative mitral valve regurgitation in patients 75\u2009years of age or older.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We retrospectively reviewed the clinical results of 343 patients aged \u226575\u2009years who underwent mitral valve repair for degenerative mitral valve regurgitation as a primary indication between January 1998 and June 2017.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The median (interquartile range) age of the patients was 79.4 (76.9, 82.9) years, and 132 (38.5%) patients were women. Concomitant procedures were performed in 123 patients: tricuspid surgery in 68 (19.8%) and a maze procedure or pulmonary vein isolation in 55 (16.0%). Operative mortality was 1.2%. Operative complications included atrial fibrillation in 37.9%, prolonged ventilation in 7.0%, pacemaker implantation in 3.8, renal failure requiring dialysis in 1.5 and stroke in 3 (0.9%). The median follow-up was 7.4\u2009years (interquartile range, 3.5\u201314.1\u2009years). The cumulative incidence rates of mitral valve reoperation were 2.2%, 3.2% and 3.2% at 1, 5 and 10\u2009years, respectively. Overall survival at 1, 5 and 10\u2009years were 95%, 83% and 51%, respectively. Older age, smoking and over and underweight were associated with increased risk of mortality, while higher left ventricular ejection fraction and hypertension were associated with reduced risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Mitral valve repair in elderly patients can be accomplished with low operative mortality and complications. Mitral valve repair in the elderly remains the preferred treatment for degenerative mitral regurgitation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezac299","type":"journal-article","created":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T19:09:31Z","timestamp":1651691371000},"source":"Crossref","is-referenced-by-count":9,"title":["Clinical outcomes of mitral valve repair for degenerative mitral regurgitation in elderly patients"],"prefix":"10.1093","volume":"62","author":[{"given":"Hidetake","family":"Kawajiri","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hartzell V","family":"Schaff","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A","family":"Dearani","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard C","family":"Daly","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin L","family":"Greason","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7398-0738","authenticated-orcid":false,"given":"Arman","family":"Arghami","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip G","family":"Rowse","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason K","family":"Viehman","sequence":"additional","affiliation":[{"name":"Division of Biomedical Statistics and Informatics, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian D","family":"Lahr","sequence":"additional","affiliation":[{"name":"Division of Biomedical Statistics and Informatics, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Gallego-Navarro","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5415-1478","authenticated-orcid":false,"given":"Juan A","family":"Crestanello","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,5,9]]},"reference":[{"key":"2022120213410218800_ezac299-B1","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/j.athoracsur.2008.05.045","article-title":"Outcomes after repair of the anterior mitral leaflet for degenerative disease","volume":"86","author":"Gillinov","year":"2008","journal-title":"Ann Thorac Surg"},{"key":"2022120213410218800_ezac299-B2","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1016\/j.jacc.2019.06.052","article-title":"Long-term results of mitral valve repair for regurgitation due to leaflet prolapse","volume":"74","author":"David","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2022120213410218800_ezac299-B3","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1016\/j.athoracsur.2016.08.076","article-title":"Valve repair is superior to replacement in most patients with coexisting degenerative mitral valve and coronary artery diseases","volume":"103","author":"Javadikasgari","year":"2017","journal-title":"Ann Thorac Surg"},{"key":"2022120213410218800_ezac299-B4","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1161\/CIRCULATIONAHA.116.023340","article-title":"Twenty-year outcome after mitral repair versus replacement for severe degenerative mitral regurgitation: analysis of a large, prospective, multicenter, international registry","volume":"135","author":"Lazam","year":"2017","journal-title":"Circulation"},{"key":"2022120213410218800_ezac299-B5","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.amjcard.2018.10.024","article-title":"Meta-analysis comparing mitral valve repair versus replacement for degenerative mitral regurgitation across all ages","volume":"123","author":"Jung","year":"2019","journal-title":"Am J Cardiol"},{"key":"2022120213410218800_ezac299-B6","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1016\/j.athoracsur.2018.03.086","article-title":"Isolated mitral valve surgery: the Society of Thoracic Surgeons adult cardiac surgery database analysis","volume":"106","author":"Gammie","year":"2018","journal-title":"Ann Thorac Surg"},{"key":"2022120213410218800_ezac299-B7","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.athoracsur.2008.03.020","article-title":"Is mitral valve repair superior to replacement in elderly patients?","volume":"86","author":"Ailawadi","year":"2008","journal-title":"Ann Thorac Surg"},{"key":"2022120213410218800_ezac299-B8","doi-asserted-by":"crossref","first-page":"1870","DOI":"10.1016\/j.athoracsur.2012.05.105","article-title":"Longitudinal outcome of isolated mitral repair in older patients: results from 14,604 procedures performed from 1991 to 2007","volume":"94","author":"Badhwar","year":"2012","journal-title":"Ann Thorac Surg"},{"key":"2022120213410218800_ezac299-B9","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/j.athoracsur.2006.03.091","article-title":"Survival advantage and improved durability of mitral repair for leaflet prolapse subsets in the current era","volume":"82","author":"Suri","year":"2006","journal-title":"Ann Thorac Surg"},{"key":"2022120213410218800_ezac299-B10","doi-asserted-by":"crossref","first-page":"I-8","DOI":"10.1161\/01.CIR.104.suppl_1.I-8","article-title":"Very long-term results (more than 20 years) of valve repair with Carpentier\u2019s techniques in nonrheumatic mitral valve insufficiency","volume":"104","author":"Braunberger","year":"2001","journal-title":"Circulation"},{"key":"2022120213410218800_ezac299-B11","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.athoracsur.2018.09.018","article-title":"Mitral valve repair versus replacement in elderly with degenerative disease: analysis of the STS adult cardiac surgery database","volume":"107","author":"Hendrix","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"2022120213410218800_ezac299-B12","first-page":"220","volume-title":"Advanced Therapy in Cardiac Surgery","author":"Seccombe","year":"1999"},{"key":"2022120213410218800_ezac299-B13","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/S0003-4975(99)01313-2","article-title":"Repair of anterior leaflet mitral valve prolapse: chordal replacement versus chordal shortening","volume":"69","author":"Phillips","year":"2000","journal-title":"Ann Thorac Surg"},{"key":"2022120213410218800_ezac299-B14","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1111\/j.1540-8191.1999.tb01280.x","article-title":"An effective technique to correct anterior mitral leaflet prolapse","volume":"14","author":"Alfieri","year":"1999","journal-title":"J Card Surg"},{"key":"2022120213410218800_ezac299-B15","volume-title":"The Statistical Analysis of Failure Time Data","author":"Kalbfleisch","year":"2011"},{"key":"2022120213410218800_ezac299-B16","first-page":"II53","article-title":"Mitral valve repair using Carpentier techniques in patients more than 70 years old. Early and late results","volume":"86","author":"Jebara","year":"1992","journal-title":"Circulation"},{"key":"2022120213410218800_ezac299-B17","doi-asserted-by":"crossref","first-page":"1904","DOI":"10.1016\/j.athoracsur.2010.07.062","article-title":"Predictors of mitral valve repair: clinical and surgeon factors","volume":"90","author":"Bolling","year":"2010","journal-title":"Ann Thorac Surg"},{"key":"2022120213410218800_ezac299-B18","doi-asserted-by":"crossref","first-page":"2265","DOI":"10.1016\/j.athoracsur.2015.11.049","article-title":"The Society of Thoracic Surgeons mitral repair\/replacement composite score: a report of the Society of Thoracic Surgeons quality measurement task force","volume":"101","author":"Badhwar","year":"2016","journal-title":"Ann Thorac Surg"},{"key":"2022120213410218800_ezac299-B19","doi-asserted-by":"crossref","first-page":"2397","DOI":"10.1016\/j.jacc.2017.02.026","article-title":"Relation of mitral valve surgery volume to repair rate, durability, and survival","volume":"69","author":"Chikwe","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2022120213410218800_ezac299-B20","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1161\/CIRCULATIONAHA.106.619239","article-title":"Surgical correction of mitral regurgitation in the elderly: outcomes and recent improvements","volume":"114","author":"Detaint","year":"2006","journal-title":"Circulation"},{"key":"2022120213410218800_ezac299-B21","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1067\/mtc.2003.406","article-title":"Late out-comes of mitral valve repair for floppy valves: implicationsfor asymptomatic patients","volume":"125","author":"David","year":"2003","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022120213410218800_ezac299-B22","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1161\/01.CIR.99.3.400","article-title":"Impactof preoperative symptoms on survival after surgical correction of organic mitral regurgitation: rationale for optimizing surgical indications","volume":"99","author":"Tribouilloy","year":"1999","journal-title":"Circulation"},{"key":"2022120213410218800_ezac299-B23","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/j.athoracsur.2019.07.014","article-title":"Degenerative mitral valve repair restores life expectancy","volume":"109","author":"Watt","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"2022120213410218800_ezac299-B24","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.1016\/j.hlc.2018.10.011","article-title":"Long-term results following repair for degenerative mitral regurgitation\u2014analysis of factors influencing durability","volume":"28","author":"Gardner","year":"2019","journal-title":"Heart Lung Circ"},{"key":"2022120213410218800_ezac299-B25","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1093\/icvts\/ivx383","article-title":"Impact of body mass index on outcomes following mitral surgery: does an obesity paradox exist?","volume":"26","author":"Rapetto","year":"2018","journal-title":"Interact CardioVasc Thorac Surg"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezac299\/43723906\/ezac299.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/62\/2\/ezac299\/47534549\/ezac299.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/62\/2\/ezac299\/47534549\/ezac299.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,2]],"date-time":"2022-12-02T13:47:47Z","timestamp":1669988867000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezac299\/6582572"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,9]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,7,11]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezac299","relation":{},"ISSN":["1010-7940","1873-734X"],"issn-type":[{"value":"1010-7940","type":"print"},{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,8,1]]},"published":{"date-parts":[[2022,5,9]]},"article-number":"ezac299"}}