Outcomes of Octogenarians Undergoing Edge-to-Edge Transcatheter Valve Repair for Tricuspid Regurgitation: Inverse Propensity Score-Weighted Analysis.

Abstract

There is a scarcity of data for perioperative outcomes of octogenarians undergoing tricuspid transcatheter edge-to-edge repair (TEER), despite both the potential procedural effectiveness in treating tricuspid regurgitation and a low incidence of severe complications observed in the non-elderly population. We assessed the characteristics and outcomes of TEER in octogenarians compared to those in patients under 80 years old treated at a referral tertiary teaching hospital. We retrospectively enrolled all adult patients undergoing tricuspid TEER. The population was stratified based on age: ≥80 and <80 years. Inverse probability of treatment weighting (IPTW) propensity score was used to mitigate the risk of selection bias. Between January 2017 and September 2023, 101 patients underwent tricuspid TEER. Thirty-six (36%) were octogenarians. Crude treatment estimates indicated that pre-surgery Tricuspid Annular Plane Systolic Excursion (TAPSE) was significantly higher in octogenarians compared to younger patients (19 mm [IQR: 17-21] vs. 17 mm [IQR: 14-18]; p=0.005). At discharge, octogenarians showed a TAPSE 2.71 mm higher than that observed in the <80 age group (95% CI: 0.79-4.62; p=0.006) according to crude treatment estimates. After adjusting with IPTW-weighting, the TAPSE difference remained significant, with octogenarians having a 2.44 mm higher TAPSE (95% CI: 0.54-4.35; p=0.012). IPTW-adjusted analyses indicated comparable clinical outcomes between the two groups. Adverse events and survival in octogenarians were similar to those observed in patients aged <80 years. Our findings indicate that age alone should not be the sole criterion to deny TEER.