{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T15:46:13Z","timestamp":1783611973882,"version":"3.55.0"},"reference-count":30,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: To optimise surgical treatment of mitral valve disease (MVD), a better understanding of gender-based differences is required. In this study, we analyse the gender-based differences among patients undergoing mitral valve surgery. Methods: Between January 2019 and December 2024, 809 consecutive patients were admitted to our centre for surgery for MVD. We analysed the patient characteristics, surgical details, postoperative and short-term outcomes of these patients. Results: Females (31.8%) undergoing mitral valve (MV) surgery were older (p &lt; 0.001). Females had a higher rate of atrial fibrillation (p &lt; 0.001), Rheumatoid arthritis (RA) (p = 0.002) and malignancy (p = 0.030). Furthermore, females were more often admitted to the intensive care unit (ICU) preoperatively (p = 0.037). Among these patients, 419 patients underwent isolated MV surgery. Furthermore, males underwent minimally invasive MV surgery more often (p = 0.004). Females had higher rates of combined MVD (p &lt; 0.001) and combined MS (p &lt; 0.001). Males had higher rates of severe mitral regurgitation (MR) (p = 0.041) and Left Atrium (LA) dilation (p = 0.004). Females exhibited higher rates of severe Tricuspid Regurgitation (TR) (p = 0.032) and pulmonary hypertension (p &lt; 0.001). males had higher rates of posterior mitral leaflet (PML) prolapse (p &lt; 0.001) and Flail leaflets (p &lt; 0.001). Males underwent mitral valve repair (MVr) more often (p = 0.002). Early MACCE were reported in 5.1% of the patients. Freedom from major adverse cardiac and cerebrovascular events (MACCE) was comparable at 1 year and three years (p = 0.548). Prognosis and freedom from events were comparable between genders. Conclusions: Mitral valve disease presents differently across genders. There exist fundamental differences in the pathophysiological processes and presentation of mitral valve disease. Mitral valve surgery can be carried out with low mortality and morbidity rates irrespective of gender.<\/jats:p>","DOI":"10.3390\/jcm14197072","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T12:46:56Z","timestamp":1759841216000},"page":"7072","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Gender-Based Analysis of Patients Undergoing Mitral Valve Surgery"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9903-3237","authenticated-orcid":false,"given":"Shekhar","family":"Saha","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Ludwig Maximillians University of Munich, 80539 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0383-0105","authenticated-orcid":false,"given":"Sophie","family":"Meerfeld","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Ludwig Maximillians University of Munich, 80539 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstanze Maria","family":"Horke","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Ludwig Maximillians University of Munich, 80539 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Steinmauer","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Ludwig Maximillians University of Munich, 80539 Munich, Germany"},{"name":"Department of Internal Medicine I, Department Clinical Medicine, TUM School of Medicine and Health, Technical University of Munich, 80333 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Ludwig Maximillians University of Munich, 80539 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd","family":"Juchem","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Ludwig Maximillians University of Munich, 80539 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1880-152X","authenticated-orcid":false,"given":"Sven","family":"Peterss","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Ludwig Maximillians University of Munich, 80539 Munich, Germany"},{"name":"University Aortic Centre Munich (LMU), LMU University Hospital, 80336 Munich, Germany"},{"name":"Department of Cardiac Surgery, LMU University Hospital, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Hagl","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Ludwig Maximillians University of Munich, 80539 Munich, Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3995-8737","authenticated-orcid":false,"given":"Dominik","family":"Joskowiak","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Ludwig Maximillians University of Munich, 80539 Munich, Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1161\/CIRCRESAHA.121.319914","article-title":"Sex Differences and Similarities in Valvular Heart Disease","volume":"130","author":"Desjardin","year":"2022","journal-title":"Circ. 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