title: Gender-related differences in patients undergoing mechanical aortic valve replacement with the CarboMedics valve.
abstract: OBJECTIVE
  The aim of this paper was to evaluate gender-related differences in patients undergoing mechanical aortic valve replacement with the CarboMedics valve.
  
  
  METHODS
  During a 20 year period, 629 patients (median age 60 years) underwent mechanical aortic valve replacement with the CarboMedics valve. Of these, 215 patients were female (34%). The median follow-up for the entire cohort was 10.2 ± 6.2 years.
  
  
  RESULTS
  In-hospital mortality for the entire cohort was 9% (male 7.3% vs. female 11.0%, P=0.005). Cox regression analysis revealed redo-surgery (HR=2.35, CI 1.35-4.08), LVEF<30% (HR=2.31, CI 1.36-3.93), age (HR=1.60, CI 1.27-2.02), as well as female gender (HR=2.07, CI 1.28-3.35) as independent predictors of survival. For male gender LVEF<30% (HR=2.47, CI 1.23-4.93) and age (HR=1.75, CI 1.25-2.43) were independent predictors of survival. For female gender, additional CABG (HR=2.15, CI 1.08-4.28), redo surgery (HR=3.64, CI 1.78-7.46) as well as age (HR=1.48, CI 1.06-2.06) were independent predictors of survival.
  
  
  CONCLUSIONS
  Gender per se is an independent risk factor of survival after mechanical aortic valve replacement. Severely impaired LVEF independently predicts survival in males whereas additional CABG and redo surgery do in females. Age affects survival in both sexes. These findings may serve as a basis for further improving gender related outcome.
authors: Department of Cardiothoracic Surgery, Medical University of Vienna, Vienna, Austria.
authors: S
authors: S
authors: Roedler
authors: J
authors: J
authors: Neuhauser
authors: G
authors: G
authors: Sodeck
authors: T
authors: T
authors: Dziodzio
authors: A
authors: A
authors: Juraszek
authors: D
authors: D
authors: Zimpfer
authors: R
authors: R
authors: Gottardi
authors: J
authors: J
authors: Holfeld
authors: D
authors: D
authors: Dunkler
authors: J
authors: J
authors: Dumfarth
authors: R
authors: R
authors: Rosenhek
authors: G
authors: G
authors: Laufer
authors: M
authors: M
authors: Grimm
authors: M
authors: M
authors: Czerny
mesh_terms: D000367:Age Factors; D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001317:Austria; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012044:Regression Analysis; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013318:Stroke Volume; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000401:mortality / Q000503:physiopathology; D016277:Ventricular Function, Left