Gender-dependent differences in patients undergoing tricuspid valve surgery

Area of Science:

• Cardiovascular Surgery
• Cardiac Surgery Outcomes
• Gender Disparities in Medicine

Background:

• Women constitute a significant majority (nearly 60%) of patients undergoing tricuspid valve (TV) surgery, particularly for redo procedures.
• Existing literature lacks comprehensive data on gender-specific epidemiology of tricuspid regurgitation and its impact on surgical outcomes.

Purpose of the Study:

• To investigate potential gender-based differences in the incidence and reasons for tricuspid regurgitation.
• To compare perioperative and postoperative outcomes between male and female patients undergoing isolated TV surgery.

Main Methods:

• Retrospective analysis of 92 patients (37 men, 55 women) who underwent isolated TV surgery for symptomatic severe tricuspid regurgitation or active endocarditis.
• Data collected included patient demographics, EuroSCORE, surgical indications (redo surgery, endocarditis), and follow-up outcomes.
• Statistical analysis, including binary logistic regression, was used to identify gender-dependent factors.

Main Results:

• No significant gender-based differences were observed in 30-day mortality, 5-year survival, or freedom from TV-related reoperation.
• Women were more likely to undergo redo surgery (65% vs. 27%) and less likely to have active endocarditis (18% vs. 62%) compared to men.
• Logistic regression identified endocarditis as less likely in men (OR 0.17), while previous cardiac surgery (OR 3.2) and permanent pacemaker presence (OR 5.9) were more likely in women.

Conclusions:

• Isolated tricuspid valve surgery demonstrated comparable postoperative outcomes between genders.
• Significant demographic differences exist regarding the indications for TV surgery, highlighting potential gender-specific treatment considerations.