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MITRAL VALVE REPAIR FOR MITRAL REGURGITATION IN THE ELDERLY: YES, WE HAVE TO, BUT LOOK AT THE ETIOLOGIES!
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  • Antonio Calafiore,
  • Massimo Di Marco,
  • Stefano Guarracini,
  • Kostas katsavrias,
  • Michele Di Mauro
Antonio Calafiore
John Paul II Foundation for Research and Treatment
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Massimo Di Marco
Ospedale Civile dello Spirito Santo
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Stefano Guarracini
Private Hospital Pierangeli Srl
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Kostas katsavrias
Henry Dunant Hospital Center
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Michele Di Mauro
Maastricht UMC+
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Abstract

The meta-analysis by Di Tommaso et al demonstrated as elderly patients with mitral regurgitation (MR) undergoing mitral valve repair (MVr) had lower short-term mortality and higher long-term survival with respect to patients undergoing mitral valve replacement (MVR). The benefit of repair is such, that initial surgical strategy is advisable in the elderly even in case of mild symptoms if compared with conservative management. However, even if repair can be performed in presence of some specific etiologies, as degenerative MR or secondary MR, there are always cases where a replacement can be an acceptable solution compared to a repair with uncertain future, regardless of our believes and our technical ability. In this subset of patients, the literature does not show any improvement in outcome of transcatheter mitral repair. Mitral valve repair has to be always done, but look at the etiologies and to the consequences that what is done today can cause tomorrow.

Peer review status:ACCEPTED

08 Mar 2021Submitted to Journal of Cardiac Surgery
09 Mar 2021Assigned to Editor
09 Mar 2021Submission Checks Completed
09 Mar 2021Editorial Decision: Accept