Key result
Very old age is linked to ~20% worse long-term survival after TEER.
Why the study?
The study investigated the influence of age, frailty, and non-cardiac comorbidities on long-term survival, healthcare resource utilization, and expenditure in real-world patients undergoing M-TEER.
Do age, frailty, and non-cardiac comorbidities predict long-term survival in patients undergoing mitral valve edge-to-edge repair?
Observational (n=4,896)
Do age, frailty, and non-cardiac comorbidities predict long-term survival in patients undergoing mitral valve edge-to-edge repair?
Odds Ratio: 1.2 (95% CI 1.07–1.49)
p-value: p=0.005
In a large real-world cohort, advanced age, frailty, and non-cardiac comorbidities significantly impaired long-term survival after M-TEER, highlighting the need for comprehensive geriatric assessment in patient selection.
Supports cautious selection for M-TEER in the very elderly; leaves open whether frailty integration improves risk stratification.
Background and aims The influence of age, frailty, and non-cardiac comorbidities on long-term survival in a large, real-world cohort of patients undergoing mitral valve edge-to-edge-repair (M-TEER) was investigated. In addition, associated healthcare resource utilization and expenditure were evaluated. Methods Demographic data, data on frailty and co-morbidities were drawn from the anonymized database of the second largest sickness fund in Germany and analysed in regards of long-term survival. Results Relevant data was available in 4896 patients. Very old patients (80–99 years) had an impaired survival as compared to younger ones (OR 1.2, 95% CI [1.07;1.49], p = 0.005). With increasing level of frailty (care level 1: OR 1.43, 95% CI [1.19;1.72], p = 0.0001; care level 2: OR 1.63, 95% CI [1.45;1.84], p < 0.0001; care level 3–5: OR 2.09, 95% CI [1.79;2.45], p < 0.0001), and increasing number of non-cardiac comorbidities (one: OR 1.55, 95% CI [1.32, 1.82], p < 0.001; two: OR 2.21, 95% CI [1.90;2.59], p < 0.001, three or more: OR 2.82, 95% CI [2.37;3.36], p < 0.001) survival was significantly impaired. Female sex seems to be protective (OR 0.75, 95% CI [0.68;0.82], p < 0.001), whereas right heart failure at baseline (OR 1.83, 95% CI [1.65;2.03], p < 0.001) has a negative effect on survival. Overall medical expenses 12-months before the procedure were equal to 12-months after M-TEER (12-months before: 5796€ IQR [856.5;14,856.0] vs. 12-months after: 4.184€ IQR [370;15,316]. Conclusion Age, frailty and comorbidities play a significant role in survival prediction of patients undergoing M-TEER. Overall medical expanses did not change after M-TEER however heart failure hospitalizations were less frequent.
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Piayda et al. (2026) conducted an observational in Mitral valve regurgitation (n=4,896). Very old age (80-99 years) vs. Younger patients (50-69 years) was evaluated on Long-term survival (OR 1.2, 95% CI 1.07-1.49, p=0.005). Very old age (80-99 years) was associated with significantly impaired long-term survival compared to younger patients undergoing mitral valve edge-to-edge repair (OR 1.2).
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