Sex-Specific Considerations in Degenerative Aortic Stenosis for Female-Tailored Transfemoral Aortic Valve Implantation Management.
Giulia MasieroValeria ParadiesAnna FranzoneBarbara BelliniChiara De BiaseNicole KaramFrancesca SanguinetiMamas Andreas MamasHélène EltchaninoffChiara FraccaroBattistina CastiglioniTiziana AttisanoGiovanni EspositoAlaide ChieffoPublished in: Journal of the American Heart Association (2022)
The impact of sex on pathophysiological processes, clinical presentation, treatment options, as well as outcomes of degenerative aortic stenosis remain poorly understood. Female patients are well represented in transfemoral aortic valve implantation (TAVI) trials and appear to derive favorable outcomes with TAVI. However, higher incidences of major bleeding, vascular complications, and stroke have been reported in women following TAVI. The anatomical characteristics and pathophysiological features of aortic stenosis in women might guide a tailored planning of the percutaneous approach. We highlight whether a sex-based TAVI management strategy might impact on clinical outcomes. This review aimed to evaluate the impact of sex from diagnosis to treatment of degenerative aortic stenosis, discussing the latest evidence on epidemiology, pathophysiology, clinical presentation, therapeutic options, and outcomes. Furthermore, we focused on technical sex-oriented considerations in TAVI including the preprocedural screening, device selection, implantation strategy, and postprocedural management.
Keyphrases
- aortic stenosis
- aortic valve
- transcatheter aortic valve implantation
- transcatheter aortic valve replacement
- aortic valve replacement
- ejection fraction
- polycystic ovary syndrome
- end stage renal disease
- left ventricular
- atrial fibrillation
- coronary artery disease
- newly diagnosed
- risk factors
- heart failure
- chronic kidney disease
- type diabetes
- prognostic factors
- pregnant women
- ultrasound guided
- insulin resistance
- glycemic control
- patient reported outcomes