{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:07:21Z","timestamp":1787656041688,"version":"build-2736575974"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,8,8]]},"abstract":"\n Background<\/jats:title>\n \n Because of demographic changes, a growing number of elderly patients present with mitral valve (\n MV<\/jats:styled-content>\n ) disease. Although mitral valve repair (\n MV<\/jats:styled-content>\n \u2010repair) is the \u201cgold standard\u201d treatment for\n MV<\/jats:styled-content>\n disease, in elderly patients, there is controversy about whether\n MV<\/jats:styled-content>\n \u2010repair is superior to mitral valve replacement. We reviewed results after\n MV<\/jats:styled-content>\n surgery in elderly patients treated over the past 20\u00a0years.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Our in\u2010hospital database was explored for patients who underwent\n MV<\/jats:styled-content>\n surgery between 1994 and 2015. Survival data, obtained from the National Health Service central register, were complete for all patients. Of 1776 patients with\n MV<\/jats:styled-content>\n disease, 341 were aged \u226575\u00a0years. Patients with repeat cardiac surgery, endocarditis, and concomitant aortic valve replacement were excluded. This yielded 221\n MV<\/jats:styled-content>\n \u2010repair and 120 mitral valve replacement patients. Concomitant procedures included coronary artery bypass grafting in 135 patients (39.6%) and tricuspid valve surgery in 50 patients (14.7%). Thirty\u2010day mortality was 5.4% (\n MV<\/jats:styled-content>\n \u2010repair) versus 9.2% (mitral valve replacement,\n P<\/jats:italic>\n =0.26). Overall 1\u2010 and 5\u2010year survival was 90.7%, 74.2% versus 81.3%, 61.0% (\n P<\/jats:italic>\n <0.01). Median survival after\n MV<\/jats:styled-content>\n \u2010repair was 7.8\u00a0years, close to 8.5\u00a0years (95%\n CI<\/jats:styled-content>\n : 8.2\u20139.4) in the age\u2010matched\n UK<\/jats:styled-content>\n population (ratio 0.9). Rate of re\u2010operation for\n MV<\/jats:styled-content>\n \u2010dysfunction was 2.3% versus 2.5% (mitral valve replacement,\n P<\/jats:italic>\n =1.0). After propensity matching, patients after\n MV<\/jats:styled-content>\n \u2010repair still had improved survival at 1, 2, and 5 years (93.4%, 91.6%, 76.9% versus 77.2%, 75.2%, 58.7%,\n P<\/jats:italic>\n =0.03).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Excellent outcomes can be achieved after\n MV<\/jats:styled-content>\n surgery in elderly patients. Long\u2010term survival is superior after\n MV<\/jats:styled-content>\n \u2010repair and the re\u2010operation rate is low.\n MV<\/jats:styled-content>\n \u2010repair should be the preferred surgical approach in elderly patients.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.003605","type":"journal-article","created":{"date-parts":[[2016,7,28]],"date-time":"2016-07-28T20:07:33Z","timestamp":1469736453000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":41,"title":["Is Mitral Valve Repair Superior to Mitral Valve Replacement in Elderly Patients? Comparison of Short\u2010 and Long\u2010Term Outcomes in a Propensity\u2010Matched Cohort"],"prefix":"10.1161","volume":"5","author":[{"given":"Miriam","family":"Silaschi","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery and Cardiology, King's College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Chaubey","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery and Cardiology, King's College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Aldalati","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery and Cardiology, King's College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habib","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery and Cardiology, King's College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Mohsin","family":"Uzzaman","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery and Cardiology, King's College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mrinal","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery and Cardiology, King's College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Baghai","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery and Cardiology, King's College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjit","family":"Deshpande","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery and Cardiology, King's College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf","family":"Wendler","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery and Cardiology, King's College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2006.11.014"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1312808"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.10.044"},{"key":"e_1_3_4_5_2","first-page":"230","article-title":"Mitral valve repair versus replacement","volume":"4","author":"Mick SL","year":"2015","unstructured":"Mick SL, Keshavamurthy S, Gillinov AM. 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