Sex-based differences in mitral valve Re-operation after mitral valve repair: Truth or myth?

Sameer A. Hirji, Camila R. Guetter, Lena Trager, Farhang Yazdchi, Samantha Landino, Jiyae Lee, Alexandra Anastasopulos, Edward Percy, Siobhan McGurk, Marc P. Pelletier, Sary Aranki, Prem S. Shekar, Tsuyoshi Kaneko

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Outcomes after mitral valve (MV) repair are known to be worse in women. Less is known about sex-based differences in MV repair durability. Methods: All adult patients undergoing MV repair from 2002 to 2016 were reviewed. Of 2463 cases, 947 (39%) were women. Re-operation risk was defined as any intervention for repair failure or MV disease progression. Median follow-up was 8.2 years. Results: Women were older with higher STS-risk scores and were more likely to have rheumatic disease (RHD). Operative mortality was clinically higher in women (2.7% vs 1.7%; P = 0.09). Although women had significantly higher 10-year re-operation risk (7% vs 4%), adjusted longitudinal analysis showed that this was associated with RHD in women (HR 4.04; P = 0.001). Female sex alone was not a significant predictor (P = 0.21). Conclusions: Re-operation following MV repair was infrequent. Women had increased re-operation risk that was largely attributable to their worse preoperative profiles rather than female sex alone.

Original languageEnglish
Pages (from-to)1344-1350
Number of pages7
JournalAmerican journal of surgery
Issue number5
StatePublished - Nov 2020


  • Gender differences
  • Mitral valve repair
  • Mitral valve surgery
  • Re-operation


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