Valvular & structural heart disease
Sex-Related Differences in Outcomes According to Surgical Treatment Approach in Degenerative Mitral Regurgitation
Authors' conclusion
In this large series of patients surgically treated for DMR, women had worse preoperative presentation, higher early postoperative rates of stroke, and higher long-term risk of mortality when treated by MVr.
Study context
- Population
- Patients surgically treated for degenerative mitral regurgitation (DMR) by mitral valve repair (MVr) or replacement (MVR) between 2002 and 2019
- Participants
- 1,804 participants
- Comparison
- Sex differences, in total population and within each treatment approach
- womenn = 661
Methodological detailsconsecutive patients, data prospectively collected, inverse probability weighting
- Consecutive patients
- Data prospectively collected
- Inverse probability weighting
Main finding
As reported in the abstract
Preoperative presentation · Preoperatively
Women presented more atrial fibrillation, higher values of brain natriuretic peptides, higher indexed values of left atrial and ventricular dimensions, and pulmonary pressure and were more symptomatic
all P ≤ 0.006
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Long-term mortality after MVr · after MVr · After inverse probability weighting | 1.62 (1.14–2.30) | P = 0.007 | |
| Long-term mortality after MVR · after MVR · After inverse probability weighting | 0.91 (0.71–1.17) | P = 0.47 | |
| 0.512Hazard ratio (log scale) |
Early stroke · short-term postoperative (≤30 days)
- Women at higher risk of early stroke
- After inverse probability weighting
Independent predictors of long-term mortality
- Men: mainly presence of mitral annulus calcification
- Women: left ventricular ejection fraction and DMR severity
- All P ≤ 0.04
Original publication
Sex-Related Differences in Outcomes According to Surgical Treatment Approach in Degenerative Mitral Regurgitation. JACC Adv. Published 7 July 2025. doi:10.
Summarised from the published abstract; every number is checked against it