Key result
Mitral valve transcatheter edge-to-edge repair in patients aged ≥85 years was associated with similar overall mid-term mortality compared to patients <85 years (5.6% vs. 7.6%, p=0.76).
Why the study?
Patients ≥ 85 years are frequently excluded from clinical studies of M-TEER for severe mitral regurgitation.
Does M-TEER with the PASCAL device have similar safety and efficacy in patients ≥ 85 years compared to patients < 85 years with severe MR?
Cohort (n=375)
No
Does M-TEER with the PASCAL device have similar safety and efficacy in patients ≥ 85 years compared to patients < 85 years with severe MR?
Absolute Event Rate: 5.6% vs 7.6%
p-value: p=0.76
M-TEER with the PASCAL device is safe and effective in patients ≥ 85 years, with procedural outcomes and mid-term mortality comparable to younger patients despite higher baseline surgical risk.
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.
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Jürgens et al. (2026) conducted a cohort in Severe mitral regurgitation (n=375). Age ≥ 85 years vs. Age < 85 years was evaluated on Overall mortality (p=0.76). Mitral valve transcatheter edge-to-edge repair in patients aged ≥85 years was associated with similar overall mid-term mortality compared to patients <85 years (5.6% vs. 7.6%, p=0.76).
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