Mitral Transcatheter Edge-to-Edge Repair in Nonagenarians.

BACKGROUND: - There is scarce data regarding mitral transcatheter edge-to-edge repair (TEER) in individuals aged 90 years and above. We aimed to evaluate patient characteristics, procedural aspects, and outcomes in this rapidly-growing group.

METHODS: - We retrospectively studied a single-center database of 967 isolated, first-time interventions, 103 (10.7%) of which were performed in nonagenarians. Outcomes included all-cause mortality, heart failure (HF) hospitalizations, and the persistence of significant mitral regurgitation (MR) or New York Heart Association functional class III/IV during the first postprocedural year. Analyses were repeated on a 204-patient, propensity score-matched sub-cohort, controlling for MitraScore elements, sex, race, MR etiology, functional status, atrial fibrillation/flutter, and procedural urgency.

RESULTS: - Compared with subjects under 90 years of age, nonagenarians were more likely to be white females of higher socioeconomic status; had a higher interventional risk, driven mainly by age and chronic kidney disease; presented more often with primary MR (71.8 vs 39.1%, p<0.001); and exhibited less advanced biochemical/echocardiographic indices of cardiac remodeling. Further, their procedures were more commonly non-urgent and utilized fewer devices. A similarly high (>97%) technical success rate was achieved in the two study groups. Likewise, no inter-group differences were observed in the rates or cumulative incidences of any of the explored endpoints, and neither of the outcomes' risks was associated with age 90 and above. Comparable outcomes were also noted in the propensity score-matched subgroups.

CONCLUSION: - In our experience, mitral TEER was equally feasible, safe, and efficacious in patients under and above 90 years of age.