Our Summary

This research paper investigates whether it is better for elderly patients with degenerative heart valve disease to have their mitral valve repaired or replaced. They looked at data from patients over the age of 75 who had either of these surgeries between 2010 and 2013. To account for other health differences between the patients, they matched them up so that each group was comparable.

They found that out of 260 patients, 145 had the repair surgery and 115 had the valve replaced. The overall results showed that patients who had their valve replaced were more likely to die in hospital than those who had it repaired. In the matched groups, there were more deaths in the replacement group compared to the repair group. The chance of survival over 1, 2, and 3 years was also higher for the repair group.

In simple terms, the study suggests that, for elderly patients with this type of heart disease, having the mitral valve repaired leads to better short-term and mid-term outcomes than having it replaced. However, the authors note that their study has limitations due to its retrospective nature.

FAQs

  1. What was the purpose of the research paper about mitral valve repair?
  2. What were the results of the comparison between mitral valve repair and replacement in elderly patients?
  3. What limitations did the authors note about their study on mitral valve repair vs replacement?

Doctor’s Tip

A helpful tip a doctor might give a patient about mitral valve repair is that it may lead to better short-term and mid-term outcomes compared to valve replacement, especially for elderly patients with degenerative heart valve disease. It is important to discuss the options with your healthcare provider to determine the best course of treatment for your individual case.

Suitable For

Patients who are typically recommended mitral valve repair are those with degenerative heart valve disease, particularly elderly patients over the age of 75. This surgery may be recommended for patients who are at a higher risk for complications from valve replacement or who have a preference for a less invasive procedure. Additionally, patients with certain underlying health conditions or risk factors may be better suited for mitral valve repair rather than replacement. Ultimately, the decision to recommend mitral valve repair will depend on the specific circumstances of each individual patient and should be made in consultation with a healthcare provider.

Timeline

Before mitral valve repair:

  1. Patient experiences symptoms such as shortness of breath, fatigue, and chest pain.
  2. Patient undergoes diagnostic tests such as echocardiogram and cardiac catheterization to determine the severity of the valve disease.
  3. Patient consults with a cardiologist and a cardiac surgeon to discuss treatment options.
  4. Decision is made to undergo mitral valve repair surgery.

After mitral valve repair:

  1. Patient undergoes pre-operative preparations such as blood tests, imaging scans, and medication adjustments.
  2. Mitral valve repair surgery is performed, either through open-heart surgery or minimally invasive techniques.
  3. Patient is monitored in the intensive care unit post-surgery for a few days.
  4. Patient undergoes cardiac rehabilitation to improve strength and endurance.
  5. Patient undergoes follow-up appointments with the cardiologist to monitor recovery and assess valve function.
  6. Patient experiences improved symptoms such as increased energy and improved exercise tolerance.

What to Ask Your Doctor

Some questions a patient should ask their doctor about mitral valve repair include:

  1. What are the risks and benefits of mitral valve repair compared to valve replacement?
  2. How will my age and overall health affect the success of the surgery?
  3. What is the expected recovery time and rehabilitation process after mitral valve repair?
  4. Are there any potential long-term complications or side effects associated with mitral valve repair?
  5. How likely is it that I will need additional surgeries or treatments in the future if I choose mitral valve repair?
  6. What is the success rate of mitral valve repair in patients with degenerative heart valve disease?
  7. Are there any alternative treatment options to consider besides mitral valve repair?
  8. How experienced is the surgical team in performing mitral valve repair procedures?
  9. What lifestyle changes or medications will I need to follow after mitral valve repair surgery?
  10. Can you provide me with more information or resources about mitral valve repair to help me make an informed decision?

Reference

Authors: Farid S, Ladwiniec A, Hernández-Sánchez J, Povey H, Caruana E, Ali A, Moorjani N, Irons J, Ring L, Abu-Omar Y. Journal: Heart Lung Circ. 2019 Feb;28(2):314-319. doi: 10.1016/j.hlc.2017.10.027. Epub 2017 Dec 5. PMID: 29246680