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Presentation and outcomes of women and men undergoing surgery for degenerative mitral regurgitation.
van Kampen, Antonia; Butte, Sophie; Paneitz, Dane C; Nagata, Yasufumi; Langer, Nathaniel B; Borger, Michael A; D'Alessandro, David A; Sundt, Thoralf M; Melnitchouk, Serguei.
Afiliación
  • van Kampen A; Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Butte S; University Clinic of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany.
  • Paneitz DC; Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Nagata Y; Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Langer NB; Department of Cardiology, Echocardiography Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Borger MA; Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • D'Alessandro DA; University Clinic of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany.
  • Sundt TM; Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Melnitchouk S; Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Eur J Cardiothorac Surg ; 66(3)2024 Sep 02.
Article en En | MEDLINE | ID: mdl-39141430
ABSTRACT

OBJECTIVES:

Degenerative mitral regurgitation is associated with heart failure, arrhythmia and mortality. The impact of sex on timing of surgical referral and outcomes has not been reported comprehensively. We examined preoperative status and surgical outcomes of male versus female degenerative mitral valve regurgitation patients undergoing surgery.

METHODS:

We reviewed our institutional database for all patients undergoing surgery for degenerative mitral regurgitation between 2013 and 2021. Preoperative clinical and echocardiographic variables, surgical characteristics and outcomes were compared, and left atrial strain in available images.

RESULTS:

Of 963 patients, 314 (32.6%) were female. Women were older (67 vs 64 years, P = 0.031) and more often had bileaflet prolapse (19.4% vs 13.8%, P = 0.028), mitral annular calcification (12.1% vs 5.4%, P < 0.001) and tricuspid regurgitation (TR; 31.8% vs 22.5%, P = 0.001). Indexed left ventricular end-diastolic and end-systolic diameters were higher in women, with 29.4 vs 26.7 mm/m2 (P < 0.001) and 18.2 vs 17 mm/m2 (P < 0.001), respectively, and left atrial conduit strain lower (17.6% vs, 21.2%, P = 0.001). Predicted risk of mortality was 0.73% vs 0.54% in men (P = 0.023). Women required mechanical circulatory support more frequently (1.3% vs 0%, P = 0.011), had longer intensive care unit stay (29 vs 26 h, P < 0.001), mechanical ventilation (5.4 vs 5 h, P = 0.036), and overall hospitalization (7 vs 6 days, P < 0.001). There was no difference in long-term reoperation-free survival (P = 0.35).

CONCLUSIONS:

Women undergoing mitral valve repair are older and show indicators of more advanced disease with long-standing left ventricular impairment. Guidelines may need to be adjusted and address this disparity, to improve postoperative recovery times and outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insuficiencia de la Válvula Mitral Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insuficiencia de la Válvula Mitral Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania