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THE JOURNAL OF CARDIOVASCULAR SURGERY

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The Journal of Cardiovascular Surgery 2011 Dicembre;52(6):887-94

lingua: Inglese

Gender-related differences in patients undergoing mechanical aortic valve replacement with the CarboMedics valve

Roedler S. 1, Neuhauser J. 1, Sodeck G. 2, Dziodzio T. 1, Juraszek A. 1, Zimpfer D. 1, Gottardi R. 1, Holfeld J. 1, Dunkler D. 1, Dumfarth J. 1, Rosenhek R. 3, Laufer G. 1, Grimm M. 1, Czerny M. 4

1 Department of Cardiothoracic Surgery, Medical University of Vienna, Vienna, Austria;
2 Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria;
3 Department of Cardiology, Medical University of Vienna, Vienna, Austria;
4 Department of Cardiovascular Surgery, University Hospital Berne, Switzerland


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AIM: The aim of this paper was to evaluate gender-related differences in patients undergoing mechanical aortic valve replacement with the CarboMedics valve.
METHODS: During a 20 year period, 629 patients (median age 60 years) underwent mechanical aortic valve replacement with the CarboMedics valve. Of these, 215 patients were female (34%). The median follow-up for the entire cohort was 10.2±6.2 years.
RESULTS:In-hospital mortality for the entire cohort was 9% (male 7.3% vs. female 11.0%, P=0.005). Cox regression analysis revealed redo-surgery (HR=2.35, CI 1.35-4.08), LVEF<30% (HR=2.31, CI 1.36-3.93), age (HR=1.60, CI 1.27-2.02), as well as female gender (HR=2.07, CI 1.28-3.35) as independent predictors of survival. For male gender LVEF<30% (HR=2.47, CI 1.23-4.93) and age (HR=1.75, CI 1.25-2.43) were independent predictors of survival. For female gender, additional CABG (HR=2.15, CI 1.08-4.28), redo surgery (HR=3.64, CI 1.78-7.46) as well as age (HR=1.48, CI 1.06-2.06) were independent predictors of survival.
CONCLUSION:Gender per se is an independent risk factor of survival after mechanical aortic valve replacement. Severely impaired LVEF independently predicts survival in males whereas additional CABG and redo surgery do in females. Age affects survival in both sexes. These findings may serve as a basis for further improving gender related outcome.

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michael.grimm@meduniwien.ac.at