Abstract 10846: Gender Differences in Outcomes of Mitraclip: A Meta-Analysis

Abstract

Introduction: With the approval of transcatheter mitral valve edge-edge repair (TEER) for secondary mitral regurgitation, there has been a significant increase in the volume of TEER. Prior investigators have explored gender differences in outcomes of Mitraclip (the only approved TEER) with mixed results. In this study, we systematically reviewed impact of gender on Mitraclip outcomes and performed a meta-analysis to examine short-term and long-term outcomes in women versus men. Hypothesis: Females undergoing TEER with Mitraclip will have higher mortality, major adverse events and less functional improvement compared to men. Methods: Pubmed, Google scholar, Cochrane database etc were searched through 31 May 2021 for published studies reporting outcomes with Mitraclip in women versus men. Meta-analysis was performed using comprehensive meta-analysis software using random effects model. Results: Ten studies (8 manuscripts and 2 abstracts) with total of 2924 males and 1816 females were analysed. The risk of death at discharge (p=0.71), at 30 days (p=0.32) and beyond 6-12 months (p=0.97) was similar. Acute procedural success (defined by mitral regurgitation grade ≤2 at 30 days), major adverse events at 1 month (p=0.064) and at 1 year (p= 0.98), risk of renal failure (p=0.15), stroke (p=0.71) and 1 year readmission rate (p=0.42) were all similar. Females received more blood transfusion than males (RR: 1.37, CI: 1.03-1.80, p=0.02). Prevalence of NYHA 3/4 class at 1 year post-procedure (RR: 1.36, CI: 1.19-1.56, p<0.01) and MLHFQ scores (RR: 1.91, CI: 1.47-2.48, p=0.01) were higher in females compared to males. Conclusions: Females have similar early and intermediate term mortality, major adverse events and rehospitalization rates compared to men following TEER with Mitraclip. However, females have less symptoms improvement as evidenced by greater frequency of NYHA class 3/4 symptoms and higher MLHFQ scores at 6-12 months after Mitraclip implantation compared to males.