In patients undergoing cryoballoon PV isolation for AF, the presence of normal PVs pattern is associated with better AF-free survival as compared to atypical PV anatomy with CLPV, particularly in patients with paroxysmal AF.
Background
Although women represent half of the population burden of aortic stenosis (AS), little is known whether sex affects the presentation, management, and outcome of patients with AS.
Methods and Results
In a cohort of 2429 patients with severe AS (49.5% women) we aimed to evaluate 5‐year excess mortality and performance of aortic valve replacement (AVR) stratified by sex. At presentation, women were older (
P
<0.001), with less comorbidities (
P
=0.030) and more often symptomatic (
P
=0.007) than men. Women had smaller aortic valve area (
P
<0.001) than men but similar mean transaortic pressure gradient (
P
=0.18). The 5‐year survival was lower compared with expected survival, especially for women (62±2% versus 71% for women and 69±1% versus 71% for men). Despite longer life expectancy in women than men, women had lower 5‐year survival than men (66±2% [expected‐75%] versus 68±2% [expected‐70%],
P
<0.001) after matching for age. Overall, 5‐year AVR incidence was 79±2% for men versus 70±2% for women (
P
<0.001) with male sex being independently associated with more frequent early AVR performance (odds ratio, 1.49; 1.18–1.97). After age matching, women remained more often symptomatic (
P
=0.004) but also displayed lower AVR use (64.4% versus 69.1%;
P
=0.018).
Conclusions
Women with severe AS are diagnosed at later ages and have more symptoms than men. Despite prevalent symptoms, AVR is less often performed in women and 5‐year excess mortality is noted in women versus men, even after age matching. These imbalances should be addressed to ensure that both sexes receive equivalent care for severe AS.
Figure-of-eight suture is a fast closure technique that can be used as an efficient alternative to usual compression methods to prevent bleeding during high-intensity anticoagulation and the use of large-diameter venous sheaths and multiple femoral venous accesses.
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