Sex-based differences in mitral valve Re-operation after mitral valve repair: Truth or myth?

Hirji, Sameer; Guetter, Camila Roginski; Trager, Lena; Yazdchi, Farhang; Landino, Samantha M.; Lee, Jiyae; Anastasopulos, Alexandra; Percy, Edward; McGurk, Siobhan; Pelletier, Marc; Aranki, Sary F.; Shekar, Prem; Kaneko, Tsuyoshi

doi:10.1016/j.amjsurg.2020.06.069

Cited by 6 publications

(17 citation statements)

References 20 publications

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“…AKI was reported in four studies postsurgical MV intervention with no significant differences between males and females. 20 – 22,24 Pooled estimates of postoperative AKI did not differ significantly with an OR of 1.23 and 95% CI of 0.89–1.70, z-score = 1.25, p = 0.21 (Fig. 3C).…”

Section: Resultsmentioning

confidence: 89%

“…Five studies included reoperation rates post MV surgery with no significant differences between males and females. 5,20 – 22,24 Pooled estimates of reoperation rates were not significantly different with an OR of 0.77 and 95% CI of 0.49–1.22, z-score = 1.11, p = 0.27 (Fig. 3B).…”

Section: Resultsmentioning

confidence: 91%

“…28 Overall, in the unmatched patient populations, the mean age of males and females ranged from 58.8 to 67.0 and 64.0 to 68.8, respectively. 4–6,22,25–28…”

Section: Resultsmentioning

confidence: 99%

“…Five studies reported postoperative stroke rates after MV surgery. 5,20 – 22,24 One study reported significant differences between the two groups with males exhibiting 2.1% postoperative stroke rates while females had 3.7% (p = 0.022). 24 Pooled estimates of postoperative stroke rates did not differ significantly with an OR of 1.11 and 95% CI of 0.61–2.02, z-score = 0.34, p = 0.74 (Fig.…”

Section: Resultsmentioning

confidence: 99%

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Does sex impact outcomes after mitral valve surgery? A systematic review and meta-analysis

et al. 2022

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Background and objective: The published literature investigating the impact of sex on outcomes after mitral valve (MV) surgery has demonstrated inferior outcomes for females over males. However, the true relationship between sex and outcomes after MV surgery continues to be poorly understood. Materials: PubMed, Medline, and Embase were systematically searched for articles published from 1 January 2005 to 1 August 2021. This systematic review included retrospective and prospective studies investigating the relationship between sex and outcomes after MV surgery. In all, 2068 articles were initially screened and 12 studies were included in this review. Results: Few studies were adequately powered or structured to investigate this topic. Few studies propensity matched patients or isolated for surgical approach. In individual studies, females experienced increased rates of short-term and long-term mortality and increased 1-year mortality in the pooled data. Males experienced increased rates of required pacemaker insertion. The remaining rates of morbidity and mortality did not differ significantly between males and females. Conclusions: This review identified increased rates of 1-year mortality in the pooled data for females, while males had increased rates of pacemaker insertion. Despite this, the absence of propensity matching and isolating for surgical approach has introduced confounding variables that impair the ability of the included studies to interpret the results found in the current literature. Studies isolating for surgical approach, propensity matching patients, and examining outcomes with long-term follow-up are required to elucidate the true nature of this relationship.

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Section: Resultsmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 91%

“…28 Overall, in the unmatched patient populations, the mean age of males and females ranged from 58.8 to 67.0 and 64.0 to 68.8, respectively. 4–6,22,25–28…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Does sex impact outcomes after mitral valve surgery? A systematic review and meta-analysis

et al. 2022

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“…Prior studies have not found gender to be an independent predictor of recurrent MR. 29 Women have had more recurrent MR after transcatheter repair of IMR. 30 More recurrent moderate regurgitation in women is consistent with previous data showing that women with DMR tend to have bileaflet prolapse 31 which, in turn, is associated with more recurrent MR. 24 Women getting mitral repair to tend to be older with more risk of fibrosis or calcification in valves undergoing repair.…”

Section: Discussionmentioning

confidence: 99%

The outcome of mitral repair for degenerative versus ischemic mitral regurgitation using a single complete ring

Bishawi

Milano

Gaca

et al. 2021

Journal of Cardiac Surgery

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Gender differences in 381 patients undergoing isolated mitral regurgitation repair

Cheng,

Ma,

Zeng

et al. 2024

Thorac Cardiovasc Surg

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Objectives To compare the gender differences in isolated mitral regurgitation (MR) repair. Methods Of 381 adults aged 54.8±12.3 years undergoing mitral valve repair (MVP) for isolated MR from 01/2019-12/2022, the baseline and operative data, and outcomes were compared between 161 women (42.3%) and 220 men (57.7%). Results Women tended to be non-smoker (98.1% vs 45%, P<0.001), and have more cerebrovascular accidents (38.5% vs 24.1%, P=0.004), lower creatinine (70.0±19.5 vs 86.3±19.9 µmol/dL, P<0.001), smaller LVEDD (54.4±6.7 vs 57.8±6.6 mm, P<0.001) and isolated annular dilatation (19.3% vs 9.1%, P=0.010). One female died of stroke at 2 days (0.3%). Another female (0.3%) underwent MV replacement for failed repair. Stroke occurred in 4 (1.0%). Two underwent re-exploration for bleeding (0.5%). Women were more likely to have less 24-hour drainage (290±143 vs 385±196 mL, P<0.001). Over a mean follow-up of 2.1±1.1 years (100% complete), one woman died, one man underwent a reoperation; 28 had moderate MR, and 9 had severe MR. Neither did early and late mortality and reoperation, nor freedom from late moderate/severe MR (71.6% vs 71.4% at 5 years; P=0.992) differ significantly between two genders. Predictors for late moderate/severe MR were anterior leaflet prolapse (hazard ratio [HR] 4.45; 95% confidence interval [CI] 1.18-16.72; P=0.027) and isolated annular dilation (HR 5.47, 95% CI 1.29-23.25; P=0.021). Conclusions Despite significant differences in smoking, cerebrovascular accidents, creatinine, LVEDD, and isolated annular dilatation at baseline, and 24-hour drainage, women and men did not show significant difference in early and late survival, reoperation and freedom from late moderate/severe MR.

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Sex-based differences in mitral valve Re-operation after mitral valve repair: Truth or myth?

Cited by 6 publications

References 20 publications

Does sex impact outcomes after mitral valve surgery? A systematic review and meta-analysis

Does sex impact outcomes after mitral valve surgery? A systematic review and meta-analysis

The outcome of mitral repair for degenerative versus ischemic mitral regurgitation using a single complete ring

Gender differences in 381 patients undergoing isolated mitral regurgitation repair

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