Transcatheter mitral valve repair is feasible and effective in oldest-old patients:results from real-world cohort

OBJECTIVE To evaluate the safety and efficacy of transcatheter mitral valve repair(TMVR)using MitraClip^(■)devices in oldest-old patients compared to younger patients.METHODS The study retrospectively included 340 consecutive patients who underwent TMVR.Patients were classified according to age into the oldest-old(age≥85 years)patient group or the younger(age<85 years)patient group.Immediate results of the procedure,intrahospital outcomes and one-year outcomes were compared.RESULTS Oldest-old patients represented 15.9%(n=54)of all patients.Procedure success was comparable for the oldest-old patient group and the younger patient group(92.6%vs.95.8%,P=0.30),and there was no difference in intrahospital mortality(9.2%vs.4.2%,P=0.12).At a one-year follow-up(interquartile range:6–16 months),there was no significant difference in rehospitalization due to decompensated heart failure(25.5%vs.34.3%,P=0.24)or all-cause mortality(29.8%vs.22.2%,P=0.26)between the oldest-old patient group and the younger patient group.In patients with available echocardiographic follow-up,severity of residual mitral regurgitation was also comparable between the oldest-old patient group and the younger patient group.CONCLUSIONS TMVR seems to be feasible and effective in oldest-old patients and should be considered for oldest-old patients presenting with symptomatic severe mitral regurgitation and high surgical risk.