Comparison of Men Versus Women Undergoing Transcatheter Mitral Valve Repair With Mitraclip

Aims: Transcatheter mitral valve repair (TMVR) with MitraClip is being used with increasing popularity for significant mitral regurgitation and suitable valve anatomy. Whether there are difference in baseline, procedural, or outcome data in men versus women undergoing this procedure is uncertain. Methods: We thus analyzed retrospectively collected data on patients undergoing TMVR at 3 tertiary care centers. Baseline, procedural, and outcome details were systematically sought. Patients were followed after discharge for clinical events and echocardiographic changes. Results: A total of 84 subjects were included: 39 (46%) males and 45 (54%) females. Women and men had significant differences in age, height, body surface area, prevalence of coronary artery disease, chronic obstructive pulmonary disease, receipt of implantable cardioverter defibrillators, and systolic dysfunction. Despite this, procedural success was similarly high in both genders, with only one procedural failure in a man. Echocardiographic follow-up showed persistent improvement in mitral regurgitation in 38 (98%) males and 45 females (100%, p=0.464), with similarly significant reductions in vena contracta (within-subject p 0.05). Conclusion: Males and females with significant mitral regurgitation and established indications to TMVR with MitraClip appear to equally benefit from this procedure, despite obvious gender-related differences in baseline features.

[1]  D. Capodanno,et al.  Gender‐related clinical and echocardiographic outcomes at 30‐day and 12‐month follow up after MitraClip implantation in the GRASP registry , 2015 .

[2]  G. Biondi-Zoccai,et al.  Heart failure with preserved ejection fraction: refocusing on diastole. , 2015, International journal of cardiology.

[3]  S. Bertog,et al.  Predictors for prolonged hospital stay after transcatheter mitral valve repair with the MitraClip® , 2014, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[4]  C. Indolfi,et al.  Implantation of More than One MitraClip in Patients Undergoing Transcatheter Mitral Valve Repair: Friend or Foe? , 2014 .

[5]  T. Beißbarth,et al.  Failure of acute procedural success predicts adverse outcome after percutaneous edge-to-edge mitral valve repair with MitraClip. , 2014, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[6]  C. Nienaber,et al.  Percutaneous mitral repair with the MitraClip system in patients with mild-to-moderate and severe heart failure: a single-centre experience. , 2014, Cardiovascular therapeutics.

[7]  S. Blankenberg,et al.  MitraClip therapy in surgical high-risk patients: identification of echocardiographic variables affecting acute procedural outcome. , 2014, JACC. Cardiovascular interventions.

[8]  P. Chan,et al.  Concept of the central clip: when to use one or two MitraClips®. , 2014, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[9]  C. McCulloch,et al.  Echocardiographic predictors of single versus dual MitraClip device implantation and long‐term reduction of mitral regurgitation after percutaneous repair , 2013, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[10]  K. Phan,et al.  A meta-analysis of MitraClip system versus surgery for treatment of severe mitral regurgitation. , 2013, Annals of cardiothoracic surgery.

[11]  E. Foster,et al.  4-year results of a randomized controlled trial of percutaneous repair versus surgery for mitral regurgitation. , 2013, Journal of the American College of Cardiology.

[12]  S. Blankenberg,et al.  Aetiology of mitral regurgitation differentially affects 2‐year adverse outcomes after MitraClip therapy in high‐risk patients , 2013, European journal of heart failure.

[13]  S. Fuchs,et al.  Gender‐related differences in hospitalized heart failure patients , 2013, European journal of heart failure.

[14]  T. Münzel,et al.  The impact of gender on fractional flow reserve measurements. , 2013, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[15]  C. Nienaber,et al.  Residual mitral valve regurgitation after percutaneous mitral valve repair with the mitraclip® system is a risk factor for adverse one‐year outcome , 2013, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[16]  K. Rufibach,et al.  Predictors for efficacy of percutaneous mitral valve repair using the MitraClip system: the results of the MitraSwiss registry , 2013, Heart.

[17]  F. Beyersdorf,et al.  Current concepts for minimally invasive mitral valve repair , 2013, Heart, lung and vessels.

[18]  N. Wenger Gender disparity in cardiovascular disease: bias or biology? , 2012, Expert review of cardiovascular therapy.

[19]  E. Foster,et al.  EVEREST II randomized clinical trial: predictors of mitral valve replacement in de novo surgery or after the MitraClip procedure. , 2012, The Journal of thoracic and cardiovascular surgery.

[20]  M. Cheitlin Percutaneous Repair or Surgery for Mitral Regurgitation , 2012 .

[21]  Pierfrancesco Agostoni,et al.  Are propensity scores really superior to standard multivariable analysis? , 2011, Contemporary clinical trials.

[22]  G. Biondi-Zoccai,et al.  Comparison of mortality rates in women versus men presenting with ST-segment elevation myocardial infarction. , 2011, The American journal of cardiology.

[23]  J. Gorman,et al.  Percutaneous repair or surgery for mitral regurgitation. , 2011, The New England journal of medicine.

[24]  O. Alfieri,et al.  Transcatheter valves and interventional cardiology. , 2011, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[25]  Antonio Colombo,et al.  Percutaneous mitral valve repair with the MitraClip system: acute results from a real world setting , 2010, European heart journal.

[26]  S. de Servi,et al.  Sex-related differences in patients undergoing percutaneous unprotected left main stenting. , 2010, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[27]  G. Biondi-Zoccai,et al.  Reduced post-infarction myocardial apoptosis in women: a clue to their different clinical course? , 2003, Heart.

[28]  G. Frati,et al.  Accessory mitral valve tissue causing left ventricular outflow tract obstruction: case reports and literature review. , 2001, The Journal of heart valve disease.