Mitral transcatheter edge-to-edge repair achieved sustained MR ≤2+ in 98.3% of patients at 1 year, yielding equivalent mortality, symptom, and quality-of-life improvements across age groups.
Does mitral transcatheter edge-to-edge repair (M-TEER) improve outcomes equally in older (≥75 years) versus younger (<75 years) patients with moderate-to-severe or severe mitral regurgitation?
M-TEER provides high procedural success and durable improvements in mitral regurgitation severity, symptoms, and quality of life that are comparable between older (≥75 years) and younger (<75 years) patients.
Absolute Event Rate: 0% vs 0%
Abstract Background/Introduction Mitral regurgitation (MR), encompassing degenerative (DMR) and functional (FMR) subtypes, is the second most prevalent valvular heart condition, linked to substantial morbidity and mortality. Mitral transcatheter edge-to-edge repair (M-TEER) offers a less invasive option for patients unsuitable for surgical intervention. Purpose This study evaluated procedural, echocardiographic, functional, and quality-of-life (QOL) outcomes in older (≥75 years) versus younger (75 years) patients undergoing M-TEER. Methods We retrospectively analyzed 118 patients with moderate-to-severe (3+) or severe (4+) MR in New York Heart Association (NYHA) class III–IV who underwent M-TEER at our institution between January 2021 and January 2025. A 1:1 propensity score match minimized baseline imbalances between age groups. Two-way repeated-measures ANOVA examined the interaction between age and time for MR grade and NYHA class; post hoc Tukey-adjusted testing identified time-point differences. Primary endpoints included procedural success, MR reduction, NYHA class change, and QOL improvement assessed by Kansas City Cardiomyopathy Questionnaire–Overall Summary (KCCQ-OS) scores at 30 days and 1 year. Results The cohort comprised 118 patients (44 matched pairs; 70% FMR) with a median age of 71 years (IQR: 12). Procedural success was 100%, with median device time of 27 minutes (IQR: 8) and total procedure time of 56 minutes (IQR: 10). Median hospital stay was 2.9 days (IQR: 0.6), and all patients were discharged home. At 1 year, heart failure hospitalization occurred in 14 patients (11.9%) and death in 11 patients (9.3%). MR severity decreased significantly from baseline to 30 days (p0.0001) and baseline to 1 year (p0.0001) (Figure 1). Severe MR was eliminated at 30 days, and MR ≤2+ was sustained in 98.3% of patients at 1 year; 24% had only mild MR at 1 year. NYHA class improved significantly from baseline to 30 days (p0.0001) and baseline to 1 year (p0.0001), with no further change between 30 days and 1 year (p=0.85) (Figure 1). At 30 days, 100% of patients were NYHA I–II, and 97.5% maintained this at 1 year; the proportion in NYHA I rose from 39% at 30 days to 45% at 1 year. KCCQ-OS improved from 52 ± 19 at baseline to 70 ± 14 at 30 days and 71 ± 15 at 1 year (p0.001) (Figure 1). In the matched analysis, severe MR at baseline was more frequent in older patients (94% vs 77%, p=0.001), but age was not associated with mortality (HR: 2.10; 95% CI: 0.84–6.20; p=0.76), heart failure hospitalization (HR: 2.70; 95% CI: 0.57–8.10; p=0.79), MR reduction (p=0.84), NYHA improvement (p=0.27), or KCCQ-OS gain (p=0.18) (Figure 2). Conclusion M-TEER yields high procedural success and durable improvements in MR severity, ventricular function, symptoms, and QOL, with benefits extending equally to elderly and younger patients. These results support M-TEER as an effective therapy for high-risk DMR and FMR populations across age groups.Figure 1For image description, please refer to the figure legend and surrounding text. Figure 2For image description, please refer to the figure legend and surrounding text.
Papadopoulos et al. (Sun,) reported a other. Mitral transcatheter edge-to-edge repair achieved sustained MR ≤2+ in 98.3% of patients at 1 year, yielding equivalent mortality, symptom, and quality-of-life improvements across age groups.