Effect of sex and surgical incision on survival after isolated primary mitral valve operations

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
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Depositing User: LivePure Connector
Date Deposited: 06 May 2022 03:56
Last Modified: 09 Nov 2022 12:30
URI: https://ueaeprints.uea.ac.uk/id/eprint/84887
DOI: 10.1093/ejcts/ezac273

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