<div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" paraid="3" paraeid="{06bf3b4c-4bc2-4d8a-ae72-adeb1febcf06}{9}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW194155813 BCX0"><span class="NormalTextRun SCXW194155813 BCX0">Long-term survival after mitral valve surgery is similar between women and men once age and procedural differences are accounted for, although recurrent mitral regurgitation (MR)<span> </span></span><span class="NormalTextRun SCXW194155813 BCX0">remains</span><span class="NormalTextRun SCXW194155813 BCX0"><span> </span>more common in women, a new meta-analysis suggests.</span></span><span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></p> </div> <div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" paraid="4" paraeid="{06bf3b4c-4bc2-4d8a-ae72-adeb1febcf06}{11}"><span class="NormalTextRun SCXW194155813 BCX0">The study, published online in<span> </span></span><em><span class="NormalTextRun SCXW194155813 BCX0">JACC: Advances</span></em><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW194155813 BCX0"><span class="NormalTextRun SCXW194155813 BCX0">, pooled data from<span> </span></span><span class="NormalTextRun SCXW194155813 BCX0">42,587 patients</span><span class="NormalTextRun SCXW194155813 BCX0"><span> </span>across 16 observational studies comparing men and women undergoing mitral valve surgery, an area where long-term, sex-specific outcomes have<span> </span></span><span class="NormalTextRun SCXW194155813 BCX0">remained</span><span class="NormalTextRun SCXW194155813 BCX0"><span> </span>incompletely understood.</span></span><span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></p> </div> <div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" paraid="5" paraeid="{06bf3b4c-4bc2-4d8a-ae72-adeb1febcf06}{13}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW194155813 BCX0"><span class="NormalTextRun SCXW194155813 BCX0">Led by Xander Jacquemyn, MD, of the University of Pittsburgh Medical Center, the researchers noted that female sex is embedded as an independent predictor of operative mortality in widely used surgical risk models, yet its long-term implications after mitral valve surgery have<span> </span></span><span class="NormalTextRun SCXW194155813 BCX0">remained</span><span class="NormalTextRun SCXW194155813 BCX0"><span> </span>uncertain.</span></span><span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></p> </div> <div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" paraid="6" paraeid="{06bf3b4c-4bc2-4d8a-ae72-adeb1febcf06}{15}"><span class="NormalTextRun SCXW194155813 BCX0">Women had worse unadjusted long-term survival and more recurrent MR than men, along with higher in-hospital mortality and more than double the rate of mitral valve replacement, the investigators reported. However, after adjustment for age and procedural differences, the survival gap closed and only the excess recurrent MR persisted.</span><span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></p> </div> <div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" paraid="7" paraeid="{06bf3b4c-4bc2-4d8a-ae72-adeb1febcf06}{17}"><span data-contrast="auto" xml:lang="EN" lang="EN" class="TextRun SCXW194155813 BCX0"><span class="NormalTextRun SCXW194155813 BCX0">"These findings highlight the importance of early referral and increased consideration of mitral valve repair, when appropriate, to improve outcomes for women," the authors<span> </span></span><span class="NormalTextRun SCXW194155813 BCX0">wrote</span><span class="NormalTextRun SCXW194155813 BCX0">.</span></span><span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></p> </div> <div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" paraid="8" paraeid="{06bf3b4c-4bc2-4d8a-ae72-adeb1febcf06}{19}"><strong><span data-contrast="auto" xml:lang="EN" lang="EN" class="TextRun MacChromeBold SCXW194155813 BCX0"><span class="NormalTextRun SCXW194155813 BCX0">Study </span><span class="NormalTextRun SCXW194155813 BCX0">d</span><span class="NormalTextRun SCXW194155813 BCX0">etails</span></span><span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" paraid="9" paraeid="{06bf3b4c-4bc2-4d8a-ae72-adeb1febcf06}{21}"><span data-contrast="auto" xml:lang="EN" lang="EN" class="TextRun SCXW194155813 BCX0"><span class="NormalTextRun SCXW194155813 BCX0">The included studies were all observational, the team<span> </span></span><span class="NormalTextRun SCXW194155813 BCX0">wrote</span><span class="NormalTextRun SCXW194155813 BCX0">, with time-to-event data reconstructed from published Kaplan-Meier curves and pooled using random-effects models. Women accounted for 39% of the 42,587 patients and were significantly older than men, by a mean of 2.8 years.</span></span><span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></p> </div> <div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" paraid="10" paraeid="{06bf3b4c-4bc2-4d8a-ae72-adeb1febcf06}{23}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW194155813 BCX0"><span class="NormalTextRun SCXW194155813 BCX0">Women were more than twice as likely as men to undergo primary mitral valve replacement rather than repair (21.9% vs 11.0%; odds ratio [OR]: 2.15; 95% CI: 1.62-2.84</span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW194155813 BCX0">)</span><span> </span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW194155813 BCX0">and</span><span class="NormalTextRun SCXW194155813 BCX0"><span> </span>had higher in-hospital mortality<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW194155813 BCX0">rates</span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW194155813 BCX0">(</span><span class="NormalTextRun SCXW194155813 BCX0">OR: 1.38; 95% CI: 1.27-1.50).</span></span><span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></p> </div> <div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" paraid="11" paraeid="{06bf3b4c-4bc2-4d8a-ae72-adeb1febcf06}{25}"><span class="NormalTextRun SCXW194155813 BCX0">In unadjusted analyses, female sex was associated with higher all-cause mortality (hazard ratio [HR]: 1.35; 95% CI: 1.25-1.47) and recurrent MR (HR: 1.57; 95% CI: 1.14-2.15), according to the researchers, while reoperation rates showed only a nonsignificant trend toward higher risk (HR: 1.35; 95% CI: 0.96-1.89).</span><span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></p> </div> <div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" paraid="12" paraeid="{06bf3b4c-4bc2-4d8a-ae72-adeb1febcf06}{27}"><span class="NormalTextRun SCXW194155813 BCX0">After adjustment, neither mortality (HR: 0.96; 95% CI: 0.91-1.01) nor reoperation (HR: 1.33; 95% CI: 0.81-2.18) differed significantly between the sexes, the authors said, noting that recurrent MR remained significantly higher in women (HR: 1.68; 95% CI: 1.13-2.51).</span><span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></p> </div> <div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" paraid="13" paraeid="{06bf3b4c-4bc2-4d8a-ae72-adeb1febcf06}{29}"><span class="NormalTextRun SCXW194155813 BCX0">Meta-regression tied a higher proportion of mitral valve replacement to increased mortality (p = 0.003), the team added, though they cautioned that the study-level analysis could not definitively attribute the excess mortality to replacement rather than repair.</span><span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></p> </div> <div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" paraid="14" paraeid="{06bf3b4c-4bc2-4d8a-ae72-adeb1febcf06}{31}"><strong><span data-contrast="auto" xml:lang="EN" lang="EN" class="TextRun MacChromeBold SCXW194155813 BCX0"><span class="NormalTextRun SCXW194155813 BCX0">The </span><span class="NormalTextRun SCXW194155813 BCX0">c</span><span class="NormalTextRun SCXW194155813 BCX0">ase for </span><span class="NormalTextRun SCXW194155813 BCX0">r</span><span class="NormalTextRun SCXW194155813 BCX0">epair</span></span><span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" paraid="15" paraeid="{06bf3b4c-4bc2-4d8a-ae72-adeb1febcf06}{33}"><span data-contrast="auto" xml:lang="EN" lang="EN" class="TextRun SCXW194155813 BCX0"><span class="NormalTextRun SCXW194155813 BCX0">The findings suggest that much of women's unadjusted survival disadvantage reflects older age at surgery and higher rates of valve replacement, not female sex itself, Jacquemyn and colleagues<span> </span></span><span class="NormalTextRun SCXW194155813 BCX0">wrote</span><span class="NormalTextRun SCXW194155813 BCX0">, leaving recurrent MR as the one outcome that stayed sex-specific after adjustment.</span></span><span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></p> </div> <div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" paraid="16" paraeid="{06bf3b4c-4bc2-4d8a-ae72-adeb1febcf06}{35}"><span class="NormalTextRun SCXW194155813 BCX0">The authors pointed to guideline thresholds for mitral surgery, based on left ventricular size and ejection fraction, that do not account for sex-related differences in cardiac dimensions and may mean women reach surgical criteria later in the disease course. Earlier referral and closer monitoring of women with moderate MR, they said, could help narrow the gap.</span><span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></p> </div> <div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" paraid="17" paraeid="{06bf3b4c-4bc2-4d8a-ae72-adeb1febcf06}{37}"><span data-contrast="auto" xml:lang="EN" lang="EN" class="TextRun SCXW194155813 BCX0"><span class="NormalTextRun SCXW194155813 BCX0">More sex-specific research is needed to define intervention thresholds tailored to women and to refine repair strategies, the authors</span><span class="NormalTextRun SCXW194155813 BCX0"><span> </span>concluded</span><span class="NormalTextRun SCXW194155813 BCX0">.</span></span><span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></p> </div> <div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" paraid="1785344408" paraeid="{06bf3b4c-4bc2-4d8a-ae72-adeb1febcf06}{39}"><strong><span class="NormalTextRun SCXW194155813 BCX0">Source:</span> <span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" lang="EN-US" paraid="18" paraeid="{3e15c2b8-4b2e-4ca5-a6f5-49dd63cb9b67}{205}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW194155813 BCX0"><span class="NormalTextRun SCXW194155813 BCX0">Jacquemyn</span><span class="NormalTextRun SCXW194155813 BCX0"><span> </span>X, Ganduboina R, Sá MP, et al.<span> </span></span><span class="NormalTextRun SCXW194155813 BCX0">Impact</span><span class="NormalTextRun SCXW194155813 BCX0"><span> </span>of Female Sex on Survival and Outcomes After Mitral Valve Surgery: A Meta-Analysis.<span> </span></span></span><em><span class="NormalTextRun SCXW194155813 BCX0">JACC Adv</span></em><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW194155813 BCX0"><span class="NormalTextRun SCXW194155813 BCX0">. 2026:<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW194155813 BCX0">Epub</span><span class="NormalTextRun SCXW194155813 BCX0"><span> </span>ahead of print.</span></span><span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></p> </div> <div class="OutlineElement Ltr SCXW194155813 BCX0"> <p class="Paragraph SCXW194155813 BCX0" lang="EN-US" paraid="1211355573" paraeid="{96f181ae-fae4-4fc1-9fcc-f6cdfee357e0}{26}"><strong><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun MacChromeBold SCXW194155813 BCX0"><span class="NormalTextRun SCXW194155813 BCX0">Image Credit: </span><span class="NormalTextRun SpellingErrorV2Themed SCXW194155813 BCX0">KawaiiS</span><span class="NormalTextRun SCXW194155813 BCX0"> – stock.adobe.com</span></span><span class="EOP Selected SCXW194155813 BCX0" data-ccp-props="{"335559738":240,"335559739":240}"> </span></strong></p> </div>