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Impact of sex on outcomes after percutaneous repair of functional mitral valve regurgitation
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  • Vincent Chan,
  • David Messika-Zeitoun,
  • Marino Labinaz,
  • Mark Hynes,
  • Donna Nicholson,
  • Adam Dryden,
  • Thierry Mesana,
  • Ben Hibbert
Vincent Chan
University of Ottawa Heart Institute
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David Messika-Zeitoun
University of Ottawa Heart Institute
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Marino Labinaz
University of Ottawa Heart Institute
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Mark Hynes
University of Ottawa Heart Institute
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Donna Nicholson
University of Ottawa Heart Institute
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Adam Dryden
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Thierry Mesana
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Ben Hibbert
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Abstract

Background The role of percutaneous repair of functional mitral regurgitation (MR) is evolving. Left ventricle remodeling is known to be different between men and women; however, outcomes following percutaneous repair of functional MR have not considered the impact of sex. Methods Between 2012 and 2018, 175 patients underwent percutaneous repair of functional MR with the Mitra Clip NT/NTR (Abbott, Irvine CA) at our institution. Patients were assessed in a dedicated clinic with a follow-up that averaged 0.7±1.2 years and extended to 5.7 years. Results Men had a larger body surface area than women (p<0.001), whereas women were more likely than men to have diabetes preoperatively (p=0.02). There were no deaths or instances of single leaflet detachment. Immediate post-procedure MR was <2+ in 158 (90%) with a mean trans-mitral valve repair gradient of 3.4±1.0 and 3.5±2.1 mm Hg, respectively for women and men (p=0.8). One- and 2-year freedom from MR >3+ was 86.0±3.5% and 77.6±5.1%, respectively. After adjusting for differences between male and female patients, women were more likely to have recurrent MR >3+ (hazard ratio 4.7, 95% confidence interval 1.2-18.4, p=0.03). Upon adjusted analysis, there was also no association between gender and survival (p=0.2). One- and 2- year survival was 69.8±4.3% and 54.3±5.5%, respectively. Conclusion Women are more likely to have recurrent severe MR after percutaneous repair of functional MR. The mechanism for this remains undetermined.

Peer review status:ACCEPTED

14 Nov 2020Submitted to Journal of Cardiac Surgery
18 Jan 2021Assigned to Editor
18 Jan 2021Submission Checks Completed
25 Jan 2021Reviewer(s) Assigned
08 Feb 2021Review(s) Completed, Editorial Evaluation Pending
08 Feb 2021Editorial Decision: Accept