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

Abstract

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<0.001, between-subject p=0.728), effective regurgitant orifice area (within-subject p<0.001, between-subject p=0.884), and systolic pulmonary artery pressure (within-subject p<0.001, between-subject p=0.282). Clinical outcomes at 12-month follow-up were also not different in males versus females, with 4 (10%) deaths in men and 11 (24%) in women (p=0.152). Sensitivity analyses limited to propensity score matched pairs confirmed the similar procedural, echocardiographic and clinical outlook in men and women (all 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.