Gender Differences in Mitral Valve Pathologies

Background: Females are reported to have poorer outcomes following cardiac surgery especially CABG procedures. Gender-specific data regarding mitral valve pathologies and outcomes following mitral valve surgery is limited. In our study, we examine the gender differences in patients undergoing mitral valve surgery at our institution.

Methods: Between July 2019 and October 2023, 692 consecutive patients underwent mitral valve surgery at our center. Among these patients, 218 (31.5%) were female and 474 (68.5%) were male. Data are presented as medians and 25th–75th percentiles, or absolute numbers and percentages.

Results: Women undergoing mitral valve surgery were older (71 [62–76] vs. 65 [56–73], p < 0.001) and had a EuroSCORE II (3.2 [1.7–6.6] vs. 2.5 [1.1–5.8], p = 0.008). Males presented with higher BMI (23.8 [20.8–27.5] vs. 25.9 [23.5–28.7], p < 0.001). Females exhibited higher rates of severe mitral valve stenosis (p < 0.001) and rheumatic heart disease (p = 0.003). Whereas men exhibited higher rates of posterior leaflet prolapse (p = 0.002) and secondary mitral regurgitation (p = 0.004). We observed no differences with regard to Barlow disease (p = 0.131), anterior leaflet prolapse (p = 0.601), and infective endocarditis (p = 0.183). Females had higher rates of atrial fibrillation (p = 0.001), pulmonary hypertension (p < 0.001), and preoperative ventilation (p = 0.020). Rates of mitral valve repair were comparable (p = 0.120) between the groups; however, men underwent minimally invasive surgery more often (p = 0.015). The ICU stay (5 [3–7 days] vs. 5 [3–7 days], p = 0.462) and in-hospital mortality (12 [5.5] vs. 24 [5.1], p = 0.854) were comparable between the groups. Survival at 1 year was comparable between the groups (91% vs. 91% p = 0.543).

Conclusion: Mitral valve surgery can be performed with good results irrespective of gender. However, there may be gender-specific differences in the presenting pathology.

Publication History

Article published online:
11 February 2025