Interventional mitral valve Edge-to-Edge Repair in patients above 85 years of age

Clin Res Cardiol (2026). DOI 10.1007/s00392-026-02870-1
F. Jürgens (Essen)¹, F. Schindhelm (Essen)¹, M. Abusharekh (Essen)², J. Kampf (Essen)¹, M. Totzeck (Essen)¹, F. Al-Rashid (Essen)¹, P. Luedike (Essen)³, T. Rassaf (Essen)¹, A.-A. Mahabadi (Essen)^1
1Universitätsklinikum Essen Klinik für Kardiologie und Angiologie Essen, Deutschland; ²Universitätsklinikum Essen, Westdeutsches Herz- und Gefäßzentrum Kardiologie Essen, Deutschland; ³Niels-Stensen-Kliniken, Marienhospital Osnabrück, Osnabrück, Germany Kardiologie Essen, Deutschland

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 often excluded in clinical studies.
Objectives: We evaluated differences of procedural characteristics and outcomes following M-TEER in patients < vs. ≥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 < vs. ≥85 years.
Results: 375 patients with moderate to severe or severe MR were eligible; 71 aged ≥85 years (87.0±1.7 years, 57.7% male) and 304 aged <85 years (75.5±10.0 years, 58.6% male). 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 group. 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 (1 death in the <85 years group). Median mid-term follow-up was 430 [164; 692] days. Overall mortality was not different for patients ≥ vs. < 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. Our results suggest the routine utilization of M-TEER for treatment of severe MR in octogenarians.