OJTS  Vol.2 No.1 , March 2012
Does Gender Affect the Outcomes of Multiple Valve Heart Surgery?
Author(s) Iskander Al-Githmi*
ABSTRACT
Background: Multiple valve surgery exposes patients to major morbidity and mortality. Little is known about the effect of gender on the outcomes of multiple valve surgery. Methods: In 69 patients who had multiple valve surgery for rheumatic valvular heart disease, 51 patients had mitral and aortic valve replacement, 9 patients had mitral and aortic valve replacement and tricuspid valve repair, 4 patients had mitral valve replacement and tricuspid valve repair, 4 patients had mitral and tricuspid valve repair, and 1 patient had mitral and tricuspid valve replacement. Outcomes were evaluated with univariate analysis. Results: Women had significantly smaller body surface area and smaller left ventricular end-systolic area than men. Women and men had similar left ventricular ejection fraction and New York Heart Association functional class. Univariate analysis showed that in women (but not men), older age, atrial fibrillation, lower left ventricular ejection fraction, and New York Heart Association functional class II and III were associated with longer hospital and intensive care unit stay. In men (but not women), longer cardiopulmonary bypass time was associated with increased left ventricular end-systolic area at 12 months after surgery. Longer aortic cross-clamp time was associated with increased left ventricular end-systolic area in men but only weakly in women. Conclusion: We concluded that gender is an independent predictor of outcomes after multiple valve heart surgery.

Cite this paper
I. Al-Githmi, "Does Gender Affect the Outcomes of Multiple Valve Heart Surgery?," Open Journal of Thoracic Surgery, Vol. 2 No. 1, 2012, pp. 1-4. doi: 10.4236/ojts.2012.21001.
References
[1]   F. H. Edwards, J. S. Carey, F. L. Grover, J. W. Bero and R. S. Hartz, “Impact of Gender on Coronary Bypass Operative Mortality,” Annals of Thoracic Surgery, Vol. 66, No. 1, 1998, pp. 125-131. doi:10.1016/S0003-4975(98)00358-0

[2]   V. Vaccarino, J. L. Abramson, E. Veledar and W. S. Weintraub, “Sex Differences in Hospital Mortality after Coronary Artery Bypass Surgery: Evidence for a Higher Mortality in Younger Women,” Circulation, Vol. 105, No. 10, 2002, pp. 1176-1181. doi:10.1161/hc1002.105133

[3]   L. L. Mickleborough, S. Carson and J. Ivanov, “Gender Differences in Quality of Distal Vessels: Effect on Results of Coronary Artery Bypass Grafting,” Journal of Thoracic and Cardiovascular Surgery, Vol. 126, No. 4, 2003, pp. 950-958. doi:10.1016/S0022-5223(02)73596-4

[4]   C. G. Koch, F. Khandwala, N. Nussmeier and E. H. Blackstone, “Gender and Outcomes after Coronary Artery Bypass Grafting: A Propensity-Matched Comparison,” Journal of Thoracic and Cardiovascular Surgery, Vol. 126, No. 6, 2003, pp. 2032-2043. doi:10.1016/S0022-5223(03)00950-4

[5]   S. S. Khan, S. Nessim, R. Gray, L. S. Czer, A. Chaux and J. Matloff, “Increased Mortality of Women in Coronary Artery Bypass Surgery: Evi-dence for Referral Bias,” Annals of Internal Medicine, Vol. 112, No. 8, 1990, pp. 561-567.

[6]   O. Bech-Hanssen, I. Wallentin, E. Houltz, M. Beckman Suurküla, S. Larsson and K. Caidahl, “Gender Differences in Patients with Severe Aortic Stenosis: Impact on Preoperative Left Ventricular Geometry and Function, as Well as Early Postoperative Morbidity and Mortality,” European Journal of Cardiothoracic Surgery, Vol. 15, No. 1, 1999, pp. 24-30. doi:10.1016/S1010-7940(98)00268-1

[7]   T. Doenst, J. Ivanov, M. A. Borger, T. E. David and S. J. Brister, “Sex-Specific Long-Term Outcomes after Combined Valve and Coronary Artery Bypass,” Annals of Thoracic Surgery, Vol. 81, No. 5, 2006, pp. 1632-1636. doi:10.1016/j.athoracsur.2005.11.052

[8]   M. Ruel, C. Bianchi, T. A. Khan, S. Xu, J. R. Liddicoat, P. Voisine, E. Araujo, H. Lyon, I. S. Kohane, T. A. Libermann and F. W. Sellke, “Gene Expression Profile after Cardiopulmonary Bypass and Cardioplegic Arrest,” Journal of Thoracic and Cardiovascular Surgery, Vol. 126, No. 5, 2003, pp. 1521-1530. doi:10.1016/S0022-5223(03)00969-3

[9]   J. S. Lawton, S. J. Brister, K. R. Petro and M. Dullum, “Surgical Revascularization in Women: Unique Intraoperative Factors and Considerations,” Journal of Thoracic and Cardiovascular Surgery, Vol. 126, No. 4, 2003, pp. 936-938. doi:10.1016/S0022-5223(03)00805-5

[10]   C. G. Koch, C. M. Mangano, N. Schwann and V. Vaccarino V, “Is It Gender, Methodology, or Something Else?” Journal of Thoracic and Cardiovascular Surgery, Vol. 126, No. 4, 2003, pp. 932-935.

 
 
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