Gender Differences in 381 Patients Undergoing Isolated Mitral Regurgitation Repair

Abstract

Abstract Objective This study aimed 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 January 2019 to December 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 nonsmokers (98.1 vs. 45%, p < 0.001), and have more cerebrovascular accidents (38.5% vs. 24.1%, p = 0.004) and isolated annular dilatation (19.3 vs. 9.1%, p = 0.010), lower creatinine (70.0 ± 19.5 vs. 86.3 ± 19.9 μmol/dL, p < 0.001), and smaller left ventricular end-diastolic diameter (LVEDD; 54.4 ± 6.7 vs. 57.8 ± 6.6 mm, p < 0.001). One female died of stroke at 2 days (0.3%). Another female (0.3%) underwent mitral valve replacement for failed repair. Stroke occurred in 4 (1.0%). Two underwent reexploration 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), 1 woman died and 1 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 or severe MR (71.6 vs. 71.4% at 5 years; p = 0.992) differ significantly between the two genders. Predictors for late moderate or 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). Conclusion In this series of patients undergoing isolated MR repair, despite significant differences in smoking, cerebrovascular accidents, creatinine, LVEDD, and isolated annular dilatation at baseline, and 24-hour drainage postoperatively, women and men did not show significant differences in early and late survival, reoperation, and freedom from late moderate or severe MR.