Article Text

other Versions

PDF
Gender Differences in the Long-term Outcomes after Valve Replacement Surgery
  1. Alexander Kulik (alex_kulik{at}yahoo.com)
  1. University of Ottawa Heart Institute, Canada
    1. B-Khanh Lam (bklam{at}ottawaheart.ca)
    1. University of Ottawa Heart Institute, Canada
      1. Fraser D. Rubens (frubens{at}ottawaheart.ca)
      1. University of Ottawa Heart Institute, Canada
        1. Paul J. Hendry (phendry{at}ottawaheart.ca)
        1. University of Ottawa Heart Institute, Canada
          1. Roy G. Masters (rmasters{at}ottawaheart.ca)
          1. University of Ottawa Heart Institute, Canada
            1. William Goldstein (wgoldstein{at}ottawaheart.ca)
            1. University of Ottawa Heart Institute, Canada
              1. Pierre Bédard (pbedard{at}ottawaheart.ca)
              1. University of Ottawa Heart Institute, Canada
                1. Thierry G. Mesana (tmesana{at}ottawaheart.ca)
                1. University of Ottawa Heart Institute, Canada
                  1. Marc Ruel (mruel{at}ottawaheart.ca)
                  1. University of Ottawa Heart Institute, Canada

                    Abstract

                    Objective: The purpose of this study was to compare the long-term outcomes of women and men after valve replacement surgery.

                    Design: Observational study.

                    Setting: Postoperative aortic valve replacement (AVR) or mitral valve replacement (MVR).

                    Patients: 3118 patients (1261 women, 1857 men) who underwent AVR or MVR between 1976 and 2006 (2255 AVR, 863 MVR), with mean follow-up of 5.6±4.5 years.

                    Main outcome measures: The independent effect of gender on the risk of long-term complications (reoperation, stroke, and death) after valve replacement surgery using multivariate actuarial methods.

                    Results: After implantation of an aortic valve bioprosthesis, women had a significantly lower rate of reoperation compared to men (comorbidity-adjusted hazard ratio [HR]: 0.4; 95% confidence intervals [CI]: 0.2, 0.9). In contrast, if an aortic mechanical prosthesis had been implanted, women were more at risk for late stroke compared to men (HR: 1.7; CI: 1.1, 2.7). After adjustment for age and co-morbidities, women had significantly better long-term survival compared to men after bioprosthetic AVR (HR: 0.5; CI: 0.3, 0.6), but there was no survival difference between genders after mechanical AVR. Trends existed towards better survival for women after bioprosthetic MVR (HR: 0.6; CI: 0.4, 1.0) and mechanical MVR (HR: 0.8; CI: 0.5, 1.1).

                    Conclusion: The long-term outcomes after valve replacement surgery differ between women and men. Although women have more late strokes after valve replacement, they undergo fewer reoperations and have better overall long-term survival compared to men.

                    Statistics from Altmetric.com

                    Request permissions

                    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.