Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Ann Thorac Cardiovasc Surg. 2023 Aug 20;29(4):192-199. doi: 10.5761/atcs.oa.22-00210. Epub 2023 Mar 10.
This study explored the sex differences in the outcomes of degenerative mitral valve repair (MVr).
From 2010 to 2019, 1069 patients who underwent MVr due to degenerative mitral disease at Beijing Anzhen Hospital were analyzed. The average patient follow-up was 5.1 years (interquartile range: 5-7 years). The primary endpoint was overall survival. Secondary endpoints were freedom from reoperation and recurrent mitral regurgitation. A propensity-matched analysis was used to compare the outcomes of males and females.
Females were older, had a higher prevalence of atrial fibrillation and moderate-to-severe tricuspid regurgitation, and had smaller left atrial, left ventricular end-diastolic, and left ventricular end-systolic diameters. Males were more likely to undergo concomitant coronary artery bypass grafting and had longer cardiopulmonary bypass and aortic cross-clamp times. The in-hospital mortality was <1% (10/1,069). After propensity score matching of 331 pairs of patients, most variables were well balanced. Before and after propensity score matching, the long-term survival and freedom from reoperation rates were similar. Males had higher durability after surgery compared with females.
Females were referred to surgery later and had more complications than males. Long-term survival and freedom from reoperation rates were not significantly different between the sexes.
本研究探讨了退行性二尖瓣修复（MVr）结局的性别差异。
从 2010 年到 2019 年，在北京安贞医院因退行性二尖瓣疾病接受 MVr 的 1069 名患者进行了分析。平均患者随访 5.1 年（四分位距：5-7 年）。主要终点是总生存率。次要终点是免于再次手术和复发性二尖瓣反流。采用倾向评分匹配分析比较男性和女性的结局。
女性年龄较大，心房颤动和中重度三尖瓣反流的患病率较高，左心房、左心室舒张末期和左心室收缩末期直径较小。男性更可能同时进行冠状动脉旁路移植术，并且体外循环和主动脉阻断时间更长。住院死亡率<1%（10/1069）。在对 331 对患者进行倾向评分匹配后，大多数变量得到很好的平衡。在进行倾向评分匹配之前和之后，长期生存率和免于再次手术的比率相似。与女性相比，男性手术后的耐久性更高。
女性接受手术的时间较晚，且并发症多于男性。男女之间的长期生存率和免于再次手术的比率没有显著差异。
