Sex-Related Differences in Clinical Presentation and Outcome of Transcatheter Aortic Valve Implantation for Severe Aortic Stenosis

Abstract

Female sex is associated with better baseline clinical characteristics and improved survival, and is identified as a predictor of midterm survival after TAVI.

Sex-related differences in left ventricular remodeling in severe aortic stenosis and reverse remodeling after aortic valve replacement: A cardiovascular magnetic resonance study

“…Evidence suggests that women have higher pre-operative morbidity and mortality 6 , and lower referral rates 7 . It remains controversial as to whether sex impacts on survival following surgical aortic valve replacement (SAVR) 8 , however, females appear to have improved long term survival following trans-catheter aortic valve replacement (TAVR) [8][9][10] . The longer life expectancy of women or other factors such as LV remodeling and myocardial…”

Transcatheter Aortic Valve Replacement in Women

“…1 Subsequently, multiple investigators have sought to define gender disparities in patients undergoing TAVR (Table I). [2][3][4][5][6][7] Early studies were predominantly single-center, real-world observational studies with relatively small sample sizes; nonetheless, some similar findings emerged. In terms of preoperative characteristics, female patients tended to have smaller body surface areas, smaller aortic annular diameters, and higher left ventricular ejection fractions (LVEF) ( Table II).…”

“…Procedural differences were most notable for smaller valve sizes in women (Table III). [2][3][4][5][6] In regard to outcomes, the investigators consistently identified a trend toward higher rates of vascular sequelae and bleeding among women who underwent TAVR (Table IV). [2][3][4][5][6] In the largest of these institutional experiences, Humphries and colleagues 5 reported significantly lower mortality rates in women than in men (median follow-up duration, 302 d; estimated 2-yr survival rate, 38.3% vs 27.9%; P=0.007).…”

“…In terms of preoperative characteristics, female patients tended to have smaller body surface areas, smaller aortic annular diameters, and higher left ventricular ejection fractions (LVEF) ( Table II). [2][3][4][5] On the other hand, the prevalence of diabetes mellitus, coronary artery disease and prior revascularization, smoking, and peripheral vascular disease was higher in men. Procedural differences were most notable for smaller valve sizes in women (Table III).…”

Another passenger for the TAVR speeding train

“…Differently from surgical series, women treated by TAVR were approximately 50% (4,6) and seems to have a significant survival advantage compared to the male patients (4,(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). The overall result of this pooled analysis of studies is shown in Figure 1.…”