Does Gender Affect the Outcomes of Multiple Valve Heart Surgery?

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.