Cardiac Valve Diseases and Treatments
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Current evidence on safety, functional outcomes, QoL, survival, emerging replacement strategies, and conservative management in elderly patients with MR is summarized.
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The prevalence of mitral regurgitation (MR), particularly degenerative MR (DMR), rises with advancing age. Elderly patients frequently carry increased surgical risk due to frailty and comorbidities, leading to a prohibitive risk of conventional surgery. For such patients, mitral transcatheter edge-to-edge repair (M-TEER) provides a minimally invasive alternative to surgical repair. Data from large registries, including TRAMI (Transcatheter Mitral Valve Interventions) and EXPAND (The MitraClip™ EXPAND Study of the Next Generation of MitraClip™ Devices), demonstrate high procedural success, low 30-day mortality (2-3%) and stroke rates (<1%), and durable improvements in functional status and quality of life (QoL) in elderly cohorts. Although definitions of "elderly" vary between studies (≥75, ≥80, or ≥85 years) and benefits are consistently observed, elderly was defined ≥75 years within this review. For selected patients unsuitable for M-TEER, transcatheter mitral valve replacement (TMVR) can achieve effective MR elimination, with reported 1-year mortality ranging from 7% to 17% in early transfemoral, transseptal experiences and up to 29% after transapical TMVR. This review summarizes current evidence on safety, functional outcomes, QoL, survival, emerging replacement strategies, and conservative management in elderly patients with MR.
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@article{Felbel2026Interventional,
title = {Interventional treatment options for elderly patients with mitral regurgitation},
author = {Dominik Felbel and Wolfgang Rottbauer and Mirjam Keßler},
journal = {Future Cardiology},
year = {2026},
doi = {10.1080/14796678.2026.2718644},
url = {https://doi.org/10.1080/14796678.2026.2718644}
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