Male-female differences and survival in patients undergoing isolated mitral valve surgery: a nationwide cohort study in the Netherlands

Mostafa M Mokhles, Sabrina Siregar, Michel I M Versteegh, Luc Noyez, Bart van Putte, Alexander B A Vonk, Jolien W Roos-Hesselink, Ad J J C Bogers, Johanna J M Takkenberg, data registry committee of the Netherlands Association for Cardio-Thoracic Surgery

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVES: The objective of this study was to compare male-female differences with respect to baseline characteristics and short-term outcome in a contemporary nationwide cohort of patients who underwent isolated mitral valve (MV) surgery.

METHODS: All patients [N = 3411; 58% males (N = 1977)] who underwent isolated MV surgery (replacement: N = 1048, 31%; reconstruction: N = 2364, 69%) in the Netherlands between January 2007 and December 2011 were included in this study. Differences in patient and procedural characteristics and in-hospital outcome were compared between male and female patients.

RESULTS: Female patients were generally older (mean age, 64 vs 61 years, P < 0.001), presented more often with pulmonary hypertension (P = 0.03) and had higher logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) I (P < 0.001). Male patients presented more often with prior coronary artery bypass graft surgery (P < 0.001) and active endocarditis (P = 0.002). Female patients underwent MV replacement more often (P < 0.001) and, in case of replacement, received stented bioprostheses more often (P < 0.001). In-hospital mortality rates after MV replacement were 7% (n = 33) and 7% (n = 40) in male and female patients, respectively (OR 1.08, 95% CI 0.67-1.75; P = 0.75). In-hospital mortality rates after MV reconstruction were 1.4% (n = 21) and 1.3% (n = 11) in male and female patients, respectively (OR 0.88, 95% CI 0.42-1.84; P = 0.74).

CONCLUSIONS: There are substantial male-female differences in patient presentation and procedural aspects in isolated MV surgery in the Netherlands. Female patients are older, have more severe disease at the time of surgery and undergo valve repair less often. Future studies are needed to identify potentially modifiable patient factors to improve the outcome of female patients with MV disease.

Original languageEnglish
Pages (from-to)482-7
Number of pages6
JournalEuropean Journal of Cardio-thoracic Surgery
Volume50
Issue number3
DOIs
Publication statusPublished - Sep 2016

Cite this

Mokhles, M. M., Siregar, S., Versteegh, M. I. M., Noyez, L., van Putte, B., Vonk, A. B. A., ... data registry committee of the Netherlands Association for Cardio-Thoracic Surgery (2016). Male-female differences and survival in patients undergoing isolated mitral valve surgery: a nationwide cohort study in the Netherlands. European Journal of Cardio-thoracic Surgery, 50(3), 482-7. https://doi.org/10.1093/ejcts/ezw151
Mokhles, Mostafa M ; Siregar, Sabrina ; Versteegh, Michel I M ; Noyez, Luc ; van Putte, Bart ; Vonk, Alexander B A ; Roos-Hesselink, Jolien W ; Bogers, Ad J J C ; Takkenberg, Johanna J M ; data registry committee of the Netherlands Association for Cardio-Thoracic Surgery. / Male-female differences and survival in patients undergoing isolated mitral valve surgery : a nationwide cohort study in the Netherlands. In: European Journal of Cardio-thoracic Surgery. 2016 ; Vol. 50, No. 3. pp. 482-7.
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title = "Male-female differences and survival in patients undergoing isolated mitral valve surgery: a nationwide cohort study in the Netherlands",
abstract = "OBJECTIVES: The objective of this study was to compare male-female differences with respect to baseline characteristics and short-term outcome in a contemporary nationwide cohort of patients who underwent isolated mitral valve (MV) surgery.METHODS: All patients [N = 3411; 58{\%} males (N = 1977)] who underwent isolated MV surgery (replacement: N = 1048, 31{\%}; reconstruction: N = 2364, 69{\%}) in the Netherlands between January 2007 and December 2011 were included in this study. Differences in patient and procedural characteristics and in-hospital outcome were compared between male and female patients.RESULTS: Female patients were generally older (mean age, 64 vs 61 years, P < 0.001), presented more often with pulmonary hypertension (P = 0.03) and had higher logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) I (P < 0.001). Male patients presented more often with prior coronary artery bypass graft surgery (P < 0.001) and active endocarditis (P = 0.002). Female patients underwent MV replacement more often (P < 0.001) and, in case of replacement, received stented bioprostheses more often (P < 0.001). In-hospital mortality rates after MV replacement were 7{\%} (n = 33) and 7{\%} (n = 40) in male and female patients, respectively (OR 1.08, 95{\%} CI 0.67-1.75; P = 0.75). In-hospital mortality rates after MV reconstruction were 1.4{\%} (n = 21) and 1.3{\%} (n = 11) in male and female patients, respectively (OR 0.88, 95{\%} CI 0.42-1.84; P = 0.74).CONCLUSIONS: There are substantial male-female differences in patient presentation and procedural aspects in isolated MV surgery in the Netherlands. Female patients are older, have more severe disease at the time of surgery and undergo valve repair less often. Future studies are needed to identify potentially modifiable patient factors to improve the outcome of female patients with MV disease.",
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author = "Mokhles, {Mostafa M} and Sabrina Siregar and Versteegh, {Michel I M} and Luc Noyez and {van Putte}, Bart and Vonk, {Alexander B A} and Roos-Hesselink, {Jolien W} and Bogers, {Ad J J C} and Takkenberg, {Johanna J M} and {data registry committee of the Netherlands Association for Cardio-Thoracic Surgery}",
note = "{\circledC} The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.",
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language = "English",
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Mokhles, MM, Siregar, S, Versteegh, MIM, Noyez, L, van Putte, B, Vonk, ABA, Roos-Hesselink, JW, Bogers, AJJC, Takkenberg, JJM & data registry committee of the Netherlands Association for Cardio-Thoracic Surgery 2016, 'Male-female differences and survival in patients undergoing isolated mitral valve surgery: a nationwide cohort study in the Netherlands' European Journal of Cardio-thoracic Surgery, vol. 50, no. 3, pp. 482-7. https://doi.org/10.1093/ejcts/ezw151

Male-female differences and survival in patients undergoing isolated mitral valve surgery : a nationwide cohort study in the Netherlands. / Mokhles, Mostafa M; Siregar, Sabrina; Versteegh, Michel I M; Noyez, Luc; van Putte, Bart; Vonk, Alexander B A; Roos-Hesselink, Jolien W; Bogers, Ad J J C; Takkenberg, Johanna J M; data registry committee of the Netherlands Association for Cardio-Thoracic Surgery.

In: European Journal of Cardio-thoracic Surgery, Vol. 50, No. 3, 09.2016, p. 482-7.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Male-female differences and survival in patients undergoing isolated mitral valve surgery

T2 - a nationwide cohort study in the Netherlands

AU - Mokhles, Mostafa M

AU - Siregar, Sabrina

AU - Versteegh, Michel I M

AU - Noyez, Luc

AU - van Putte, Bart

AU - Vonk, Alexander B A

AU - Roos-Hesselink, Jolien W

AU - Bogers, Ad J J C

AU - Takkenberg, Johanna J M

AU - data registry committee of the Netherlands Association for Cardio-Thoracic Surgery

N1 - © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

PY - 2016/9

Y1 - 2016/9

N2 - OBJECTIVES: The objective of this study was to compare male-female differences with respect to baseline characteristics and short-term outcome in a contemporary nationwide cohort of patients who underwent isolated mitral valve (MV) surgery.METHODS: All patients [N = 3411; 58% males (N = 1977)] who underwent isolated MV surgery (replacement: N = 1048, 31%; reconstruction: N = 2364, 69%) in the Netherlands between January 2007 and December 2011 were included in this study. Differences in patient and procedural characteristics and in-hospital outcome were compared between male and female patients.RESULTS: Female patients were generally older (mean age, 64 vs 61 years, P < 0.001), presented more often with pulmonary hypertension (P = 0.03) and had higher logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) I (P < 0.001). Male patients presented more often with prior coronary artery bypass graft surgery (P < 0.001) and active endocarditis (P = 0.002). Female patients underwent MV replacement more often (P < 0.001) and, in case of replacement, received stented bioprostheses more often (P < 0.001). In-hospital mortality rates after MV replacement were 7% (n = 33) and 7% (n = 40) in male and female patients, respectively (OR 1.08, 95% CI 0.67-1.75; P = 0.75). In-hospital mortality rates after MV reconstruction were 1.4% (n = 21) and 1.3% (n = 11) in male and female patients, respectively (OR 0.88, 95% CI 0.42-1.84; P = 0.74).CONCLUSIONS: There are substantial male-female differences in patient presentation and procedural aspects in isolated MV surgery in the Netherlands. Female patients are older, have more severe disease at the time of surgery and undergo valve repair less often. Future studies are needed to identify potentially modifiable patient factors to improve the outcome of female patients with MV disease.

AB - OBJECTIVES: The objective of this study was to compare male-female differences with respect to baseline characteristics and short-term outcome in a contemporary nationwide cohort of patients who underwent isolated mitral valve (MV) surgery.METHODS: All patients [N = 3411; 58% males (N = 1977)] who underwent isolated MV surgery (replacement: N = 1048, 31%; reconstruction: N = 2364, 69%) in the Netherlands between January 2007 and December 2011 were included in this study. Differences in patient and procedural characteristics and in-hospital outcome were compared between male and female patients.RESULTS: Female patients were generally older (mean age, 64 vs 61 years, P < 0.001), presented more often with pulmonary hypertension (P = 0.03) and had higher logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) I (P < 0.001). Male patients presented more often with prior coronary artery bypass graft surgery (P < 0.001) and active endocarditis (P = 0.002). Female patients underwent MV replacement more often (P < 0.001) and, in case of replacement, received stented bioprostheses more often (P < 0.001). In-hospital mortality rates after MV replacement were 7% (n = 33) and 7% (n = 40) in male and female patients, respectively (OR 1.08, 95% CI 0.67-1.75; P = 0.75). In-hospital mortality rates after MV reconstruction were 1.4% (n = 21) and 1.3% (n = 11) in male and female patients, respectively (OR 0.88, 95% CI 0.42-1.84; P = 0.74).CONCLUSIONS: There are substantial male-female differences in patient presentation and procedural aspects in isolated MV surgery in the Netherlands. Female patients are older, have more severe disease at the time of surgery and undergo valve repair less often. Future studies are needed to identify potentially modifiable patient factors to improve the outcome of female patients with MV disease.

KW - Journal Article

U2 - 10.1093/ejcts/ezw151

DO - 10.1093/ejcts/ezw151

M3 - Article

VL - 50

SP - 482

EP - 487

JO - European Journal of Cardio-thoracic Surgery

JF - European Journal of Cardio-thoracic Surgery

SN - 1010-7940

IS - 3

ER -