Sex Disparities in In-Hospital Outcomes After Transcatheter Edge-to-Edge Mitral Valve Repair: A National Inpatient Sample Analysis, 2016–2022

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Mitral regurgitation undergoing transcatheter edge-to-edge mitral valve repair (TEER) (n=64905). Intervention: Female sex vs. Male sex. Primary outcome: In-hospital mortality (aOR 0.96, 95% CI 0.71-1.30).

Q: What does this research mean for the field?

In-hospital mortality after transcatheter edge-to-edge mitral valve repair does not differ by sex, although women experience significantly higher rates of cardiac tamponade, major bleeding, and nonhome discharge. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Brett David Cohen; Nicholas Roma; Luke Miller; Michael Durkin

doi:10.1016/j.shj.2026.101098

July 22, 2026Structural HeartOpen Access

Sex Disparities in In-Hospital Outcomes After Transcatheter Edge-to-Edge Mitral Valve Repair: A National Inpatient Sample Analysis, 2016–2022

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Key result

Women undergoing transcatheter edge-to-edge mitral valve repair had similar in-hospital mortality compared to men (aOR 0.96) but experienced significantly higher rates of cardiac tamponade and major bleeding.

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Why the study?

Contemporary national-scale evidence on sex-specific in-hospital outcomes after transcatheter edge-to-edge mitral valve repair (TEER) through 2022 remains limited.

Does female sex affect in-hospital mortality and complication rates in patients undergoing transcatheter edge-to-edge mitral valve repair?

Study Design

Type

Observational (n=64,905)

Multicenter

Yes

Structured PICO

Does female sex affect in-hospital mortality and complication rates in patients undergoing transcatheter edge-to-edge mitral valve repair?

P

Population

64,905 US hospitalizations for transcatheter edge-to-edge mitral valve repair between 2016 and 2022, analyzed to evaluate sex-specific in-hospital outcomes.

E

Exposure

Female sex (observational comparison of sex disparities in TEER recipients)

C

Comparator

Male sex (observational comparison of sex disparities in TEER recipients)

O

Outcome

In-hospital mortalityhard clinical

Main Result

Odds Ratio: 0.96 (95% CI 0.71–1.3)

Absolute Event Rate: 1.98% vs 1.75%

Limitations

NIS administrative coding lacks left ventricular ejection fraction, mitral regurgitation mechanism and severity, hemodynamics, NYHA class, frailty indices, and procedural detail.
Mitral regurgitation etiology was inferred by proxy.
Sex was a binary administrative variable rather than self-reported gender identity.
Without a present-on-admission flag, on-admission events may be misclassified as in-hospital complications.
Operator-level volume could not be modeled.
Mortality and complications were ascertained only during the index hospitalization.
NIS lacks left ventricular ejection fraction, mitral regurgitation mechanism and severity, hemodynamics, NYHA class, and procedural detail
Mitral regurgitation etiology was inferred by proxy
Sex was a binary administrative variable rather than self-reported gender identity
Without a present-on-admission flag, on-admission events may be misclassified as in-hospital complications
Operator-level volume could not be modeled
Mortality was ascertained only during the index hospitalization

Implication

While in-hospital mortality after TEER is similar between sexes, women face a significantly higher risk of periprocedural complications including tamponade and major bleeding.

Abstract

•This research correspondence examines transcatheter edge-to-edge mitral valve repair (TEER) in 64,905 US hospitalizations (National Inpatient Sample [NIS] 2016-2022). Women represented 45.8% of recipients.•In-hospital mortality did not differ by sex (adjusted odds ratio [aOR] 0.96, 95% CI 0.71-1.30).•Women had higher tamponade, major bleeding, transfusion, and nonhome discharge.•Women had lower in-hospital implantable cardioverter-defibrillator (ICD)/cardiac resynchronization-defibrillator (CRT-D) placement after TEER (aOR 0.46).•Bleeding and tamponade gaps were consistent across mitral regurgitation etiology proxy strata.

Discussion

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Cite This Study

Cohen et al. (2026) conducted an observational in Mitral regurgitation undergoing transcatheter edge-to-edge mitral valve repair (TEER) (n=64,905). Female sex vs. Male sex was evaluated on In-hospital mortality (aOR 0.96, 95% CI 0.71-1.30). Women undergoing transcatheter edge-to-edge mitral valve repair had similar in-hospital mortality compared to men (aOR 0.96) but experienced significantly higher rates of cardiac tamponade and major bleeding.

synapsesocial.com/papers/6ac478b1f8151bbe242045b8 https://doi.org/10.1016/j.shj.2026.101098

Topics

Heart failure

HFrEF treatment

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Sex Disparities in In-Hospital Outcomes After Transcatheter Edge-to-Edge Mitral Valve Repair: A National Inpatient Sample Analysis, 2016–2022

Figures

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Topics

Sex Disparities in In-Hospital Outcomes After Transcatheter Edge-to-Edge Mitral Valve Repair: A National Inpatient Sample Analysis, 2016–2022

Figures

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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