Key result
Female sex was associated with similar early mortality and major postoperative complication rates compared to male sex following surgical or transcatheter aortic valve interventions.
Why the study?
SAVR in females has been linked to higher mortality and complications than in males, though TAVI offers greater relative benefit in women; contemporary early outcomes across both modalities needed assessment.
Does female sex affect early mortality and major postoperative complication rates in patients undergoing contemporary aortic valve interventions for severe aortic stenosis compared to male sex?
Cohort (n=955)
No
Does female sex affect early mortality and major postoperative complication rates in patients undergoing contemporary aortic valve interventions for severe aortic stenosis compared to male sex?
Contemporary aortic valve interventions (TAVI and SAVR) yield similar early mortality and major complication rates in women compared to men, despite women presenting at an older age and with higher EuroSCORE II.
Supports similar early outcomes for women undergoing aortic valve replacement; observational data leaves open need for prospective validation.
Surgical aortic valve replacement (SAVR) in female patients has been associated with higher mortality (up to 3.3-8.9%) and postoperative complication rates when compared with their male counterparts. In recent years, TAVI has been shown to provide a greater benefit than SAVR in women. We sought to assess the early outcomes of the contemporary aortic valve intervention practice (surgical and transcatheter) in patients referred to our cardiac surgery unit. The data of consecutive patients who underwent isolated aortic valve intervention for aortic valve stenosis during the 2018-2022 period were retrieved from our internal database. Several preoperative, intraoperative, and postoperative variables were analyzed, including the predicted risk of a prosthesis-patient mismatch. Nine hundred and fifty-five consecutive patients-514 women and 441 men-were included. Among them, 480 patients-276 female and 204 male-received a transcatheter procedure, and 475-238 women and 237 men-had conventional SAVR. The women were older and had higher EuroSCORE II, while the male patients presented a higher incidence of cardiovascular comorbidities. There was no difference in mortality or major postoperative complication rates after either the surgical or transcatheter procedures between the female and male populations. The availability and targeted use of different techniques and technologies have enabled the safe and effective treatment of female patients treated for severe symptomatic aortic valve stenosis with similar results when compared with their male counterparts.
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Malvindi et al. (2023) conducted a cohort in Severe symptomatic aortic valve stenosis (n=955). Female sex vs. Male sex was evaluated on Mortality or major postoperative complication rates. Female sex was associated with similar early mortality and major postoperative complication rates compared to male sex following surgical or transcatheter aortic valve interventions.
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