Gender Influence on the Long-Term Outcomes of Percutaneous Balloon Mitral Valvuloplasty in Rheumatic Mitral Stenosis Patients

Background: There is a clear female predominance in rheumatic mitral stenosis (RMS) and mostly present at working-age. Percutaneous balloon mitral valvuloplasty (PBMV) is the standard treatment for RMS with suitable echocardiographic score. Many conflicting studies reported that the outcomes of PBMV are affected by gender, both males and females, or a lack thereof. Methodology: Single-centre retrospective long-term follow up of 212 patients undergoing PBMV between 2004 and 2023. Clinical, echocardiographic, and hemodynamic data were gathered and analysed with all-cause mortality, and composite outcomes of stroke, mortality, and mitral valve (MV) surgery. Results: There was no statistical significance in long-term outcomes of PBMV between males and females over the median follow-up period of 7.31 years. Advancing age (HR = 1.06, p-value = 0.002), increasing left atrium diameter (HR = 1.86, p-value = 0.017), pulmonary artery systolic pressure (HR = 1.03, p-value = 0.002) were found as independent predictors of long-term all-cause mortality for PBMV patients through COX regression analysis. Conclusion: The long-term outcomes of PBMV were not affected by gender but advancing age, increasing LA diameter and PASP, in turns PH, were independent risk factors. Early detection and intervention are vital to the prognosis of RMS patients undergoing PBMV. Institutional Review Boards in Mahidol University: COA No. MURA2024/444