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

Mhd Nawar Alachkar; Annemarie Kirschfink; Anas Alnaimi; Jörg Schröder; Felix Vogt; Nikolaus Marx; Ertunc Altiok; Mohammad Almalla

doi:10.11909/j.issn.1671-5411.2022.10.004

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

J Geriatr Cardiol. 2022 Oct 28;19(10):761-767. doi: 10.11909/j.issn.1671-5411.2022.10.004.

Authors

Mhd Nawar Alachkar¹, Annemarie Kirschfink², Anas Alnaimi², Jörg Schröder², Felix Vogt², Nikolaus Marx², Ertunc Altiok², Mohammad Almalla²

Affiliations

¹ Department of Cardiology and Angiology, REGIOMED Hospital Coburg, Coburg, Germany.
² Department of Cardiology, Angiology and Intensive Care, Medical Clinic I, University Hospital RWTH Aachen, Aachen, Germany.

PMID: 36338281
PMCID: PMC9618849
DOI: 10.11909/j.issn.1671-5411.2022.10.004

Abstract

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.