Harvard Heart Letter

Ask the doctor: Is mitral valve surgery safe for an 82-year-old?

Ask the doctor

Is mitral valve surgery safe for an 82-year-old?

Q. My 82-year-old father needs to have his mitral valve fixed. It took him a long time to recover from having an aortic aneurysm repaired, so he is procrastinating on the valve operation. Can he put it off? If not, are there alternatives to open-heart surgery?

A. Your father is justified in worrying about having a major operation like this at his age. Complications and surgery-related death are much more common among older people. At the same time, not having the operation could also be life-threatening. A leaky mitral valve makes the heart work harder than it should. When it can no longer pump enough blood to meet the body's needs, blood can back up into the lungs, making breathing difficult. This valve problem can lead to heart failure and unstable heart rhythms, both of which can interfere with daily life and be deadly. Fixing the valve can add years to your dad's life and improve his quality of life.

The outlook for valve repair in the elderly is much better than it used to be. In a report in the July 25, 2006, Circulation, doctors from the Mayo Clinic showed dramatic improvements in the success of mitral valve operations for people ages 75 and older over the past 25 years. The chances of dying as a result of the operation dropped from above 25% in 1980 to about 5%.

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