Gender impact on the efficacy of edge-to-edge percutaneous mitral valve repair in patients with mitral regurgitation

Abstract Background To date there are no studies analyzing the effect of gender on edge to edge percutaneous mitral valve repair. Purpose We aimed to investigate the effect of female sex on the effectiveness of edge-to-edge percutaneous mitral valve repair in patients with mitral regurgitation. Method A total of 220 consecutive patients (149 men and 71 women) with severemitral regurgitation were treated with edge-to-edge percutaneous repair between November 2011 and January 2025 in our hospital, and included in this prospective, monocentric, cohort study. We compared baseline clinical and echocardiographic characteristics, as well as procedural outcomes and survival following treatment basedon sex. Results Women were older, more fragile, and had a higher surgical risk compared tomen (table). They also had a higher prevalence of chronic kidney disease (table). Thediastolic diameter of the left ventricle (LVDD) was greater in men than in women(65±10 mm vs 59±10 mm, p=0.000) (Table). Median (p25-75) follow-up of patients was 27 (9-54) months. Probability of overall survival at median follow up was 70% in menvs 75% in women and survival free from heart failure hospitalization or death was 53 vs 52% respectively, without significant differences between both sexes (figure, panels Aand B). Conclusion Women with severe mitral insufficiency treated with percutaneous edge-to-edge repair are older and have a higher pre-intervention risk profile compared to men. Despite this, procedural success and overall survival, as well as heart failure-free survival during follow-up, are similar between both sexes.overall and event free survival Baseline features of the patients