Impact of Gender on Outcomes of Transcatheter edge to edge mitral valve repair: A Meta-analysis.

Background: Gender disparities in outcomes after mitral valve surgery are well known. There are only few studies reporting the influence of gender on outcomes following transcatheter edge to edge repair (TEER) of the mitral valve using MitraClip (MC). In this meta-analysis, we describe outcomes by gender after mitral valve TEER. Methods: Studies reporting gender specific outcomes in patients treated with MC were reviewed from January 2010 to February 2022. Outcomes evaluated include all-cause mortality, New York Heart Association (NYHA) class, readmission for heart failure and residual mitral regurgitation (MR) at the longest follow up. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using random effects models. Results: Seventeen studies with 33,747 patients (19,303 males and 14,444 females) were included. There was no difference in all-cause mortality (OR: 1.00, 95% CI: [0.90-1.12], p=0.93), residual MR (OR: 0.59, 95% CI: [0.34-1.02], p=0.06) or readmission for heart failure (OR: 1.04, 95% CI: [0.69-1.57], p=0.83). However, NYHA class III/IV was more frequent in female patients as compared to male patients at the end of follow up (OR: 0.62, 95% CI: [0.51-0.74], p<0.00001). Conclusions: Our meta-analysis, the largest to date, suggests that female patients have worse NHYA functional class after TEER without any difference in all-cause mortality, readmissions for heart failure or residual MR when compared to male patients.