title: Percutaneous mitral valve repair with the MitraClip system in the elderly: One-year outcomes from the GRASP registry.
abstract: BACKGROUND
  Although mitral regurgitation (MR) affects a relevant and increasing number of elderly, an optimal management of this high-risk population is challenging.
  
  
  RESULTS
  The aim of this prospective, observational study was to compare one-year outcomes of MitraClip therapy in high surgical risk patients with moderate-to-severe or severe MR between patients aged <75 versus ≥75years. A total of 180 patients were included: 92 were <75years and 88 were ≥75years old. At one-year follow-up the primary efficacy endpoint (composite of death, surgery for mitral valve dysfunction and grade 3+ or 4+ MR) occurred in 41 patients (24.5%), with similar rates between those aged <75years (23.9%) and those ≥75years (25.2%), p=0.912. A total of 21 (12.2%) deaths were observed within 1year after the MitraClip procedure, without significant differences in cumulative mortality rates between elderly and younger patients (10.8% vs. 13.3%, respectively, p=0.574). Compared with baseline, the significant reduction in MR severity achieved after the procedure was sustained at one-year follow-up, in both elderly and younger patients and a significant improvement in NYHA functional class was observed in both groups. A total of 18 (10.0%) patients experienced a re-hospitalization for acute heart failure within one-year after the MitraClip procedure, with no significant differences between elderly and younger. At one-year follow-up both elderly and younger patients showed significant reductions in left ventricular volumes, with changes of similar extent between the two subgroups.
  
  
  CONCLUSIONS
  MitraClip therapy can be considered a viable option also among subsets with more advanced age.
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Scandura
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy. Electronic address: pcapranzano@gmail.com.
authors.forename: Piera
authors.initials: P
authors.lastname: Capranzano
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Caggegi
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Grasso
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ronsivalle
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Sarah
authors.initials: S
authors.lastname: Mangiafico
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Ohno
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Guilherme F
authors.initials: GF
authors.lastname: Attizzani
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cannata
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Sandra
authors.initials: S
authors.lastname: Giaquinta
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Farruggio
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Ministeri
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Dipasqua
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Pistritto
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Immè
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Capodanno
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Di Salvo
authors.affiliation: Cardiovascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D004452:Echocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies; D020379:Risk Adjustment / Q000379:methods*; D012720:Severity of Illness Index
keywords: Elderly; MitraClip; Mitral valve