Impact of Gender on Three-Month Outcome and Left Ventricular Remodeling After Transfemoral Transcatheter Aortic Valve Implantation

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

“…The AR regurgitant fraction following valve replacement was similar between sexes which may explain why our findings differ from those of Stangl et al where rates of residual AR were much higher in men than women 13 . A significant reduction in valve gradients was observed in both sexes, with no significant difference in CMR derived peak valve gradient according to sex, suggesting that patient prosthesis mismatch was not an implicating factor in remodeling parameters according to sex.…”

“…So, the greater absolute LV mass regression seen in men was a result of the fact that men have more LV mass at baseline than their female counterparts, rather than a sex-related difference per se. Stangl et al found a better LVEF at baseline and a more favourable LV remodeling response in women upon serial echocardiography following TAVR, but their female population had higher pre-TAVR aortic valve gradients than men, which may explain the greater degree of mass regression seen 13 .In an echocardiographically based study of 92 patients undergoing SAVR for isolated AS, Petrov et al 14 found a similar LVMi at baseline in men and women, but a greater degree of LVM regression in women after SAVR. This study was based on measurements taken only 3 days post-SAVR.…”

“…suggest that men and women remodel differently to the pressure overload of AS 11,12 and may also reverse remodel differently following AVR 13,14 . CMR imaging is the reference standard for LV mass and volume quantitation, with low intra-observer and inter-study variability.…”

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).…”

Risk and Outcome of Aortic Valve Surgery in the Transcatheter Valve Era: The Gender Aspect

“…Observed 30-day survival of female TAVI patients in our center is 3.4%. 14) Many recent studies revealed that several available risk algorithms including LES and north-American pendant STS-score seem to over-predict the actual risk of mortality for aortic valve surgery patients especially in the group of high risk elderly patients. 15,16) Therefore in our multidisciplinary heart team we did not only consider the isolated results of calculated LES, but evaluated and discussed every patient's morbidity profile individually.…”