Interventional Mitral Valve Edge‐to‐Edge Repair in Patients Above 85 Years of Age
Florian Jürgens, Florian Schindhelm, Mohammed Abusharekh, Jürgen Kampf, Matthias Totzeck, Fadi Al‐Rashid, Peter Lüdike, Tienush Rassaf, Amir A. MahabadiABSTRACT
Background
Mitral valve transcatheter‐edge‐to‐edge repair (M‐TEER) is routinely performed in patients with severe mitral regurgitation (MR) at high operative risk, frequently including elderly patients. Patients ≥ 85 years, however, are frequently excluded in clinical studies.
Objectives
We evaluated differences of procedural characteristics and outcomes following M‐TEER in patients < versus ≥ 85 years.
Methods
We retrospectively included consecutive patients with severe MR who underwent M‐TEER with the PASCAL device between 2019 and 2024 at our center. Baseline and procedural characteristics, short‐ and mid‐term outcomes were compared, stratifying the cohort into patients < versus ≥ 85 years.
Results
Three hundred seventy‐five patients with moderate to severe or severe MR were eligible; 71 aged ≥ 85 (87.0 ± 1.7 years, 57.7% male) and 304 aged < 85 (75.5 ± 10.0 years, 58.6% male) years. Patients aged ≥ 85 years more frequently had severe MR (90.1% vs. 73.8%, p = 0.005) and higher STS‐Score (6.4 [3.8; 9.1] vs. 3.5 [2.2; 6.5], p < 0.0001) at baseline. No leaflet injury, single leaflet detachment or any other device‐related complication was observed, irrespective of age. Residual MR at 90 days was comparable among age groups (Trace: 34.8% vs. 23.8%; mild: 41.3% vs. 57.3%; moderate: 23.9% vs. 18.5%; moderate‐severe: 0% vs. 0.4%, p = 0.56). Within 30 days, no death occurred in patients aged ≥ 85 years (one death in the < 85 years group). Median mid‐term follow‐up was 430 [164; 692] days. Overall mortality was not different for patients ≥ versus < 85 years (5.6% vs. 7.6%, p = 0.76).
Conclusion
M‐TEER is safe in patients ≥ 85 years, with procedural outcomes and mid‐term prognosis similar to younger cohorts.