The Crack and the Light: Revisiting the Female Paradox after Transcatheter Aortic Valve Replacement

Q: What does this research mean for the field?

Women undergoing transcatheter aortic valve replacement experience higher 30-day mortality and complication rates driven primarily by life-threatening bleeding and vascular access issues, but achieve a sustained long-term survival advantage over men. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Ovidio De Filippo; Antonio Dalu; Fabrizio D’Ascenzo; Federico Conrotto

doi:10.1016/j.shj.2026.101107

August 1, 2026Structural HeartOpen Access

The Crack and the Light: Revisiting the Female Paradox after Transcatheter Aortic Valve Replacement

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Why the study?

Does female sex affect mortality and complication rates in patients undergoing TAVR compared to male sex?

Structured PICO

Does female sex affect mortality and complication rates in patients undergoing TAVR compared to male sex?

P

Population

481,353 patients undergoing transcatheter aortic valve replacement (TAVR) across 71 studies

I

Intervention

Transcatheter aortic valve replacement (TAVR) in women

C

Comparator

Transcatheter aortic valve replacement (TAVR) in men

O

Outcome

All-cause mortality at 30 days and up to 10 yearshard clinical

Limitations

Reliance on reconstructed rather than genuinely patient-level data cannot substitute for propensity-matched or multivariable-adjusted comparison
Cardiovascular mortality analyses did not account for competing noncardiovascular death
Considerable number of secondary, landmark, subgroup, and meta-regression analyses raises the concern of multiplicity

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Implication

Women undergoing TAVR face higher 30-day mortality and bleeding risks compared to men, but this early hazard reverses by 1 year into a long-term survival advantage.

Abstract

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Discussion

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Cite This Study

Filippo et al. (2026) studied this question.

synapsesocial.com/papers/6a71b733c47350ef8e494e4c https://doi.org/10.1016/j.shj.2026.101107

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The Crack and the Light: Revisiting the Female Paradox after Transcatheter Aortic Valve Replacement

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

The Crack and the Light: Revisiting the Female Paradox after Transcatheter Aortic Valve Replacement

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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