B-63 | Comparison of Procedural Characteristics and Outcomes in Men versus Women Undergoing Mitral Edge to Edge Repair

Among patients undergoing mitral transcatheter edge to edge repair (M-TEER), there is paucity of data regarding sex differences. We performed an observational study of 380 patients undergoing M-TEER at a single institution between (2014-2022). Baseline characteristics, procedural variables and outcomes were compared between men and women. A total of 176 (46%) women and 204 (56%) men were treated with M-TEER during the study period. Women were older than men [W: median age 80 years (72-86) vs. M: 78 (69-84), p=0.055) but had less co-morbidities including diabetes (W:24% vs. M:38%, p=0.005), previous CABG surgery (W:15 % vs. M:30%, p=0.001), or an implantable cardioverter defibrillator (ICD) (W:16% vs. M:31%, p=0.001) resulting in similar STS scores (W:4.4 [2.1-9.4] vs. M:4.4 [2.7-6.9], p=0.812). Women had smaller left ventricular end-systolic (W: 3.7 ± 1.2 cm vs. M:4.6 ± 1.2 cm, p<0.001), diastolic dimensions (W:5.1 ± 0.9 vs. M:5.7 ± 1.0, p<0.001), and higher ejection fraction (W: 56% [38-61] vs. M: 44% [29-58], p<0.001] than men. There were no differences in MR severity or etiology (primary vs. secondary). Women required fewer devices (W:1 clip 78% vs. M:1 clip 61% p=0.002) and achieved similar rates of MR reduction (residual MR ≥ moderate W: 5%, M: 9%, p=0.126) but with higher residual gradients (W: 4 [3, 5] mmHg, M: 3 [2,4] mmHg, p=0.002). There were no differences in survival at discharge, 30-days, or 1-year. MACE (stroke, MI, all-cause mortality) did not differ between sexes at discharge, 30-days, or 1-year. Women undergoing M-TEER achieved similar rates of MR reduction as men but with fewer clips and higher residual gradients. No sex differences were observed in clinical outcomes.