Valvular & structural heart diseaseMeta-analysis
Impact of Female Sex on Survival and Outcomes After Mitral Valve Surgery
- systematic review and meta-analysis
- random-effects models
- time-to-event data reconstructed
- meta-regression
Authors' conclusion
Women are more likely to undergo mitral valve replacement and have higher recurrent regurgitation, whereas adjusted mortality is similar, suggesting potential benefit of repair-focused strategies when feasible.
Study context
- Population
- Men and women undergoing surgical mitral valve surgerypatients in sixteen studies
- Participants
- 42,587 men
- Comparison
- female sex vs men undergoing surgical mitral valve surgery
Pooled result
Primary mitral valve replacement
Odds ratio
2.15
95% CI 1.62–2.84
By group
Women vs Men
OR 2.15 (95% CI 1.62–2.84)
As reported in the abstract
Further pooled results
| Outcome | Estimate | |
|---|---|---|
| In-hospital mortality | OR 1.38 (95% CI 1.27–1.50) | |
| All-cause mortality — Women vs Men · unadjusted | HR 1.35 (95% CI 1.25–1.47) | |
| All-cause mortality — Women vs Men · adjusted; not significantly different | HR 0.96 (95% CI 0.91–1.01) | |
| Recurrent MR — Women vs Men · unadjusted | HR 1.57 (95% CI 1.14–2.15) | |
| Recurrent MR — Women vs Men · adjusted; remained higher in women | HR 1.68 (95% CI 1.13–2.51) | |
| Reoperation — Women vs Men · unadjusted; similar | HR 1.35 (95% CI 0.96–1.89) | |
| Reoperation — Women vs Men · adjusted; not significantly different | HR 1.33 (95% CI 0.81–2.18) | |
| 0.20.5125Ratio (log scale) |
| Outcome | mean difference (years) (95% CI) | |
|---|---|---|
| Age · women significantly older than men | 2.8 (1.5–4.0) | |
| −20246Difference, years (linear scale) |
Proportion of women in cohort
- Women accounted for (95% CI: 36%-42%)
- 39%
Meta-regression: mitral valve replacement proportion and mortality in women
- higher mitral valve replacement proportion was associated with increased mortality in women
Original publication
Impact of Female Sex on Survival and Outcomes After Mitral Valve Surgery. JACC Adv. Published 20 May 2026. doi:10.1016/j.jacadv.2026.102721
Summarised from the published abstract; every number is checked against it