ArticleEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2022
Sex-specific differences and postoperative outcomes of minimally invasive and sternotomy valve surgery.
Article in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Sex-Related Outcome After Sutureless Aortic Valve Replacement With Perceval Plus: Results From a Global Registry and Meta-Regression.Interdisciplinary cardiovascular and thoracic surgery · 2026Pooled it
- Feasibility and early safety of minimally invasive lower median sternotomy in aortic valve replacement.Surgery open science · 2026Article
- Early outcomes and resource utilization across contemporary transcatheter and surgical valve interventions: a single-center observational study.BMC research notes · 2026Observational
- Evolving Perspectives in Surgery for Mitral Regurgitation: Why Sex Matters.Journal of the American Heart Association · 2025Review
- The Role of Minimally Invasive Surgery in Mitral Valve Repair: Through the Female Gaze.Journal of clinical medicine · 2025Review
- Sex-related differences in systemic inflammatory response and outcomes after cardiac surgery and cardiopulmonary bypass.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- The influence of sex on neuroimmune communication, pain, and physiology.Biology of sex differences · 2024Review
- Propensity Matched Outcomes of Minimally Invasive Mitral Surgery: Does a Heart-Team Approach Eliminate Female Gender as an Independent Risk Factor?Journal of personalized medicine · 2023Article
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10 authors at 6 institutions in 3 countries.
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Abstract
objectivesFemale sex is an established risk factor for postoperative complications after heart surgery, but the influence of sex on outcomes after minimally invasive cardiac surgery (MICS) for valvular replacement/repair remains controversial. We examined whether the role of sex as a risk factor varies by surgical approach [MICS vs conventional sternotomy (ST)] and further assessed outcomes among female patients including in-hospital mortality and postoperative complications by surgical approach.
methodsWe analysed data from a multicentre registry for patients who underwent isolated aortic valve and mitral surgery with MICS or ST. The primary outcome was in-hospital mortality. Propensity score matching was used to minimize between-group differences.
resultsAmong the 15 155 patients included in the study, 7674 underwent MICS (50.6%). Female sex was equally distributed in the MICS and ST groups (47.3% vs 47.6%, respectively). Risk for surgery was higher in the ST group than in the MICS group {EuroSCORE II: 4.0 [standard deviation (SD): 6.8] vs 3.7 [SD: 6.4]; P = 0.005}, including among female patients only [ST vs MICS 4.6 (SD: 6.9) vs 4.2 (SD: 6.3); P = 0.04]. Mortality did not significantly vary by procedure among women [MICS vs ST, 2.4% vs 2.8%; hazard ratio 1.09, 95% confidence interval 0.71-1.73; P (surgical approach × sex) = 0.51]. The results also did not vary after adjusting for confounders.
conclusionsFemale sex was associated with higher mortality in patients undergoing valve surgery, regardless of surgical approach. In female patients, MICS did not provide any benefits over ST in terms of in-hospital deaths or postoperative complications. SUBJECT COLLECTION: 117, 125.
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