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Mitral valve repair or replacement in elderly people.

Publication ,  Journal Article
Sfeir, PM; Jebara, VA; Ayoub, CM
Published in: Curr Opin Anaesthesiol
February 2006

PURPOSE OF REVIEW: Much has been published so far to describe and praise the benefits of mitral valve repair, and to compare it with valve replacement. Now, with mitral valve surgery in elderly people gaining greater acceptance worldwide, repair or replacement remains a controversial issue. This is especially true in the ageing population, in whom many of the complications associated with a mechanical valve can be avoided by using a bioprosthesis. This review will try to assess the latest views in the field and come up with possible answers to this ongoing question. RECENT FINDINGS: The causes of mitral regurgitation in this age group are separately reviewed and discussed in the light of our better understanding of the pathophysiology of the disease. Mitral surgery is recommended when the effective regurgitant orifice reaches 40 mm. Repair in degenerative disease seems to be feasible, with good long-term results. In chronic ischaemic regurgitation, the concept of a tethered 'normal valve' is changing. The 'poor' ventricle may be able to withstand surgery as long as the subvalvular apparatus is preserved; on the other hand, repair and replacement seem to have the same survival advantage in high-risk patients. SUMMARY: Mitral valve surgery is well tolerated in elderly people. Early intervention leads inevitably to better outcome. The majority of valvular disorders in this age group are amenable to repair, with good reproducible results. Replacement with a bioprosthesis remains a viable option for complex regurgitant jets.

Duke Scholars

Published In

Curr Opin Anaesthesiol

DOI

ISSN

0952-7907

Publication Date

February 2006

Volume

19

Issue

1

Start / End Page

82 / 87

Location

United States

Related Subject Headings

  • Myocardial Ischemia
  • Mitral Valve Insufficiency
  • Mitral Valve
  • Humans
  • Heart Valve Prosthesis Implantation
  • Heart Valve Prosthesis
  • Calcinosis
  • Anesthesiology
  • Aged
  • 3202 Clinical sciences
 

Citation

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Sfeir, P. M., Jebara, V. A., & Ayoub, C. M. (2006). Mitral valve repair or replacement in elderly people. Curr Opin Anaesthesiol, 19(1), 82–87. https://doi.org/10.1097/01.aco.0000192771.79032.29
Sfeir, Pierre M., Victor A. Jebara, and Chakib M. Ayoub. “Mitral valve repair or replacement in elderly people.Curr Opin Anaesthesiol 19, no. 1 (February 2006): 82–87. https://doi.org/10.1097/01.aco.0000192771.79032.29.
Sfeir PM, Jebara VA, Ayoub CM. Mitral valve repair or replacement in elderly people. Curr Opin Anaesthesiol. 2006 Feb;19(1):82–7.
Sfeir, Pierre M., et al. “Mitral valve repair or replacement in elderly people.Curr Opin Anaesthesiol, vol. 19, no. 1, Feb. 2006, pp. 82–87. Pubmed, doi:10.1097/01.aco.0000192771.79032.29.
Sfeir PM, Jebara VA, Ayoub CM. Mitral valve repair or replacement in elderly people. Curr Opin Anaesthesiol. 2006 Feb;19(1):82–87.

Published In

Curr Opin Anaesthesiol

DOI

ISSN

0952-7907

Publication Date

February 2006

Volume

19

Issue

1

Start / End Page

82 / 87

Location

United States

Related Subject Headings

  • Myocardial Ischemia
  • Mitral Valve Insufficiency
  • Mitral Valve
  • Humans
  • Heart Valve Prosthesis Implantation
  • Heart Valve Prosthesis
  • Calcinosis
  • Anesthesiology
  • Aged
  • 3202 Clinical sciences