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Dębski, Maciej 
ORCID: https://orcid.org/0000-0002-3669-3916, Taylor, Rebecca, Abdelrahman, Amr, Dębska, Karolina, Assaf, Omar, Qadri, Syed, Wong, Kenneth Y-K, Vassiliou, Vassilios ORCID: https://orcid.org/0000-0002-4005-7752 and Zacharias, Joseph
(2022)
Effect of sex and surgical incision on survival after isolated primary mitral valve operations.
European Journal of Cardio-Thoracic Surgery, 62 (5).
ISSN 1010-7940
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Abstract
OBJECTIVES: Multiple studies have suggested that women have worse outcomes than men following mitral valve (MV) surgery-most of those studies reported on conventional sternotomy (CS) MV surgery. Therefore, we aimed to explore whether or not the minimally invasive mitral valve surgery (MIMVS) approach might mitigate a worse survival in women following MV surgery. METHODS: We identified patients with isolated primary MV operations with or without tricuspid valve repair performed between 2007 and 2019. Patients were propensity score-matched across the MIMVS and CS surgical approaches. Sex was excluded from the matching process to discern whether female patients had a different likelihood of receiving minimally invasive surgery than males. A Cox proportional hazards model was fitted in the matched cohort and adjusted for the imbalance in baseline characteristics using the propensity score. RESULTS: Of 956 patients (417 MIMVS, 539 CS; 424 females), the matched set comprised 342 pairs (684 patients; 296 females) of patients who were well balanced across MIMVS and CS groups with regard to preoperative clinical characteristics. We observed a 47/53% female/male ratio in the CS group and a 39/61% in the MIMVS group, P = 0.054. In both matched groups, women were older than males. A Cox model adjusted for propensity scores showed no survival difference with sex, surgical type or interaction. CONCLUSIONS: Women present to the surgical team at an older age. They appear less likely to be considered for a MIMVS approach than men. Neither sex nor surgical approach was associated with worse survival in a matched sample.
| Item Type: | Article |
|---|---|
| Additional Information: | Funding: Maciej Dębski is an Academic Clinical Fellowsupported by the National Institute for Health and Care Research (award number ACF-2020-15-001). |
| Uncontrolled Keywords: | gender,minimally invasive surgery,mitral valve,outcomes,techniques,surgery,pulmonary and respiratory medicine,cardiology and cardiovascular medicine ,/dk/atira/pure/subjectarea/asjc/2700/2746 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 06 May 2022 03:56 |
| Last Modified: | 19 Oct 2023 03:19 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/84887 |
| DOI: | 10.1093/ejcts/ezac273 |
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