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Sex Difference in Outcomes Following Transcatheter Aortic Valve Replacement in Bicuspid Aortic Stenosis.
He, Jing-Jing; Xiong, Tian-Yuan; Yao, Yi-Jun; Peng, Yong; Wei, Jia-Fu; He, Sen; Chen, Yong; Li, Qiao; Zhao, Zhen-Gang; Wei, Xin; Zhou, Wen-Xia; Liang, Yu-Jia; Tang, Hong; Chen, Guo; Zhou, Xuan; Zheng, Ming-Xia; Meng, Wei; Liao, Yan-Biao; Li, Yi-Jian; Li, Yi-Ming; Chen, Fei; Ou, Yuan-Weixiang; Liu, Qi; Li, Xi; Wang, Xi; Zhang, Yi; Zhu, Zhong-Kai; Yang, Hao-Ran; Jia, Kai-Yu; Chen, Mao; Feng, Yuan.
Afiliação
  • He JJ; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Xiong TY; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Yao YJ; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Peng Y; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Wei JF; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • He S; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Chen Y; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Li Q; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Zhao ZG; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Wei X; Department of Cardiology, Section of Cardiac Ultrasound, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Zhou WX; Department of Cardiology, Section of Cardiac Ultrasound, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Liang YJ; Department of Cardiology, Section of Cardiac Ultrasound, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Tang H; Department of Cardiology, Section of Cardiac Ultrasound, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Chen G; Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Zhou X; Department of Radiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Zheng MX; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Meng W; Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Liao YB; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Li YJ; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Li YM; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Chen F; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Ou YW; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Liu Q; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Li X; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Wang X; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Zhang Y; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Zhu ZK; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Yang HR; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Jia KY; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
  • Chen M; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China. Electronic address: hmaochen@vip.sina.com.
  • Feng Y; Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China. Electronic address: fynotebook@hotmail.com.
JACC Cardiovasc Interv ; 15(16): 1652-1660, 2022 08 22.
Article em En | MEDLINE | ID: mdl-35981839
BACKGROUND: It is unknown whether the sex difference whereby female transcatheter aortic valve replacement (TAVR) candidates had a lower risk profile, a higher incidence of in-hospital complications, but more favorable short- and long-term survival observed in tricuspid cohorts undergoing TAVR would persist in patients with bicuspid aortic valves (BAVs). OBJECTIVES: The aim of this study was to reexamine the impact of sex on outcomes following TAVR in patients with BAVs. METHODS: In this single-center study, patients with BAVs undergoing TAVR for severe aortic stenosis from 2012 to 2021 were retrospectively included. Baseline characteristics, aortic root anatomy, and in-hospital and 1-year valve hemodynamic status and survival were compared between sexes. RESULTS: A total of 510 patients with BAVs were included. At baseline, women presented with fewer comorbidities. Men had a greater proportion of Sievers type 1 BAV, higher calcium volumes (549.2 ± 408.4 mm3 vs 920.8 ± 654.3 mm3; P < 0.001), and larger aortic root structures. Women experienced more vascular complications (12.9% vs 4.9%; P = 0.002) and bleeding (11.1% vs 5.3%; P = 0.019) and higher residual gradients (16.9 ± 7.7 mm Hg vs 13.2 ± 6.4 mm Hg; P < 0.001), while men were more likely to undergo second valve implantations during index TAVR (6.3% vs 15.9%; P = 0.001). Death at 1 year was not significantly different between sexes (HR: 1.15; 95% CI: 0.56-2.35; P = 0.70). Bleeding (adjusted HR: 4.62; 95% CI: 1.51-14.12; P = 0.007) was the single independent predictor of 1-year death for women. CONCLUSIONS: In patients with BAVs undergoing TAVR, women presented with fewer comorbidities, while men had a greater proportion of type 1 BAV, more calcification, and larger aortic roots. In-hospital outcomes favored men, with fewer complications except for the need for second valve implantation, but 1-year survival was comparable between sexes.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Estenose da Valva Aórtica / Substituição da Valva Aórtica Transcateter / Doença da Válvula Aórtica Bicúspide Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Estenose da Valva Aórtica / Substituição da Valva Aórtica Transcateter / Doença da Válvula Aórtica Bicúspide Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male Idioma: En Ano de publicação: 2022 Tipo de documento: Article