Acute and 30-Day Outcomes in Women After TAVR

Abstract

Women enrolled in this first ever all-female TAVR registry with collection of female sex-specific baseline parameters, were at intermediate-high risk and experienced a 30-day VARC-2 composite safety endpoint of 14.0% with a low incidence of early mortality and stroke. Randomized assessment of TAVR versus surgical aortic valve replacement in intermediate risk women is warranted to determine the optimal strategy.

Management of coronary obstruction following transcatheter aortic valve replacement

“…The incidence of this complication is still low (<1%). 8,9 Mutidetector CT studies reveal a smaller sinus of Valsalva, sinotubular junction, and ascending aorta in females when compared to males. 10 This was noted despite correcting for smaller body surface area.…”

“…Coronary occlusion is more commonly seen in females compared to males. The incidence of this complication is still low (<1%) . Mutidetector CT studies reveal a smaller sinus of Valsalva, sinotubular junction, and ascending aorta in females when compared to males .…”

The gender paradox in TAVR

“…With similar degree of outflow tract obstruction, cardiac performance is more frequently depressed in men compared to women. In women there is predominant hypertrophy rather than dilation and preserved systolic function (9). These differences may be related to high estrogen levels, which have protective effects on cell survival while causing downregulation in gene expression of collagen I & II and MMP-2.…”

Sex-Based Differences in Coronary and Structural Percutaneous Interventions

“…As the use of structural heart interventions has increased, so has the recognition of sex-specific characteristics and risk. This led to the creation of the Women’s International Transcatheter Aortic Valve Implantation (WIN-TAVI) Real-World Registry [ 64 ]. This was related in part to the recognition that sex-specific factors as illustrated can influence indications, outcomes, and mortality.…”