Abstract 2707: Survival of Octogenarians Undergoing Concomitant Mitral Valve Surgery and Coronary Artery Bypass in Northern New England
Background: As life expectancy increases, surgeons are performing more valve replacements with coronary artery bypass graft (CABG) surgery on patients 80 years and over. We examined the in-hospital and long-term mortality for these patients undergoing concomitant mitral valve (MV) replacement or repair with CABG.
Methods: This is a prospective regional cohort study of 2,443 consecutive patients undergoing MV repair/replacement with CABG in Northern New England from 1992 through 2005.. Long-term data was available through 2001.
Results: Of the 2,443 patients undergoing MV with CABG, 251 (10.3%) were octogenarians, of those, 37% (n=94) had replacement, 56% (n=140) had repair and 7%(n=17) had an attempted repair that was converted to a replacement. Overall crude in-hospital mortality was 17.7% (19.1%, 17.1%, 11.8% for replacement, repair and replacement plus repair, respectively). Patients >=80 had more degenerative and less ischemic disease than younger patients. Median survival overall was 3.6 yrs, with an annual incidence rate of death of 25.2% (deaths per 100 person years). Median survival for replacement vs. repair was 3.3 vs. 3.6 years (incidence rates were 25.6% and 25.1%). After adjustment for patient and disease characteristics, there was no increased risk of death for MV replacement vs. repair (HR 0.9, 95% CI, 0.6–1.4, p=0.626).
Conclusions: Conclusive outcome data in the surgical literature on octogenarians undergoing MV surgery with concomitant CABG is quite sparse. Our study examined the in-hospital and long-term mortality for these patients. Median survival for this group was 3.6 years. In-hospital and long-term mortality for MV replacement and MV repair did not differ. Cardiac surgeons who council octogenarians with mitral valvular and coronary artery disease can provide accurate mortality data in this group of patients.