Sex-specific differences and postoperative outcomes of minimally invasive and sternotomy valve surgery
| Autor: | Domenico Paparella, Nicola Di Bari, Roberto Lorusso, Giuseppe Nasso, Marco Moscarelli, Gianni D Angelini, Khalil Fattouch, Francesca Fiorentino, Giuseppe Speziale, Alberto Albertini |
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| Přispěvatelé: | CTC, MUMC+: MA Med Staf Spec CTC (9), RS: Carim - V04 Surgical intervention |
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
Aortic valve Male medicine.medical_specialty Valve surgery Heart Valve Prosthesis Implantation/methods Sternotomy/adverse effects Minimally invasive surgery Minimally invasive cardiac surgery medicine Minimally Invasive Surgical Procedures/adverse effects Humans Minimally Invasive Surgical Procedures Risk factor HIGH-RISK PATIENTS Aortic Valve/surgery Retrospective Studies Heart Valve Prosthesis Implantation Postoperative mortality GENDER-DIFFERENCES business.industry Hazard ratio Confounding Postoperative outcomes General Medicine Length of Stay Female sex Sternotomy Confidence interval Surgery TRIALS medicine.anatomical_structure Treatment Outcome Aortic Valve Propensity score matching SURVIVAL Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Moscarelli, M, Lorusso, R, Angelini, G D, Di Bari, N, Paparella, D, Fattouch, K, Albertini, A, Nasso, G, Fiorentino, F & Speziale, G 2022, ' Sex-specific differences and postoperative outcomes of minimally invasive and sternotomy valve surgery ', European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, vol. 61, no. 3, pp. 695-702 . https://doi.org/10.1093/ejcts/ezab369 European Journal of Cardio-Thoracic Surgery, 61(3), 695-702. Oxford University Press |
| ISSN: | 1873-734X 1010-7940 |
| DOI: | 10.1093/ejcts/ezab369 |
| Popis: | OBJECTIVES Female 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. METHODS We 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. RESULTS Among 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. CONCLUSIONS Female 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. |
| Databáze: | OpenAIRE |
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