Sex-Based Outcomes of Mitral Surgery for Ischemic Mitral Regurgitation

Abstract

Surgical outcomes for ischemic mitral regurgitation (IMR) in females compared to males remain unclear. The goal of this thesis was to assess sex-based outcomes in patients undergoing surgery for chronic IMR through two distinct projects. First, the IMR literature was reviewed through a systematic review and meta-analysis to compare surgical outcomes of mitral valve surgery for IMR in females and males. There were no significant sex-based differences in long-term and operative mortality, heart failure rehospitalization and mitral reinterventions, but females had higher rates of MR recurrence than males. Second, a cohort study with 1086 patients (30.4% females) with IMR was conducted. In this cohort, after inverse-probability of treatment weighting and multivariate adjustment, all-cause 30-day mortality was higher in females, but long-term mortality was similar between sexes. This thesis further supports the need for inclusion of more females in cardiovascular research and for systematic reporting of sex- and gender-specific data.