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Gender Differences in 381 Patients Undergoing Isolated Mitral Regurgitation Repair.

Yu-Hua Cheng1, Wei-Guo Ma2, Jian-Wen Zeng3

  • 1Department of Anesthesiology, Wuhan Asia Heart Hospital, Wuhan, People's Republic of China.

The Thoracic and Cardiovascular Surgeon
|August 8, 2024
PubMed
Summary

Gender differences in isolated mitral regurgitation repair showed distinct baseline characteristics but similar long-term outcomes. Women had fewer smokers and less drainage, while men had better kidney function, yet survival and reoperation rates were comparable.

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Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Outcomes
  • Mitral Valve Repair

Background:

  • Isolated mitral regurgitation (MR) repair is a common cardiac procedure.
  • Understanding potential gender-specific differences in patient characteristics and outcomes is crucial for personalized treatment strategies.

Purpose of the Study:

  • To compare gender differences in baseline characteristics, operative data, and outcomes following isolated mitral regurgitation repair.

Main Methods:

  • Retrospective analysis of 381 adult patients undergoing mitral valve repair for isolated MR between January 2019 and December 2022.
  • Comparison of baseline demographics, comorbidities, operative variables, and postoperative outcomes between women (n=161) and men (n=220).
  • Long-term follow-up (mean 2.1 years) assessed mortality, reoperation, and freedom from moderate to severe MR.

Main Results:

  • Women presented with distinct characteristics: higher rates of cerebrovascular accidents and isolated annular dilatation, lower creatinine, and smaller left ventricular end-diastolic diameter (LVEDD).
  • Postoperatively, women had significantly less 24-hour drainage compared to men.
  • Despite baseline differences, early and late mortality, reoperation rates, and freedom from moderate or severe MR at 5 years were not significantly different between genders (71.6% vs. 71.4%). Anterior leaflet prolapse and isolated annular dilation predicted late moderate or severe MR.

Conclusions:

  • While significant gender-based differences exist in baseline comorbidities and certain perioperative parameters for isolated mitral regurgitation repair, these do not translate into significant differences in long-term survival or repair durability.
  • The study highlights the importance of considering specific anatomical predictors for recurrent MR rather than gender alone.