1Herzzentrum der Universität zu Köln Klinik III für Innere Medizin Köln, Deutschland; 2Universitätsmedizin der Johannes Gutenberg-Universität Mainz Kardiologie 1, Zentrum für Kardiologie Mainz, Deutschland; 3Herz- und Diabeteszentrum NRW Allgemeine und Interventionelle Kardiologie/Angiologie Bad Oeynhausen, Deutschland; 4Universitätsklinikum Köln Klinik für Herzchirurgie, herzchirurgische Intensivmedizin und Thoraxchirurgie Köln, Deutschland; 5Universitätsklinikum Köln Klinik und Poliklinik für Herz- und Thoraxchirurgie, Herzzentrum Köln, Deutschland; 6Herz- und Diabeteszentrum NRW Klinik für Thorax- und Kardiovaskularchirurgie Bad Oeynhausen, Deutschland; 7Herzzentrum der Universität zu Köln Klinik für Kardiologie, Angiologie, Pneumologie und Internistische Intensivmedizin Köln, Deutschland
Methods: This retrospective observational study includes patients from three high-volume sites across Germany. Ninety-six patients with severe AR underwent transfemoral TAVI treatment using the JenaValve Trilogy System [JenaValve Technology, Irvine, CA]. Outcomes are reported according to the Valve Academic Research Consortium (VARC)-3 criteria.
Results: Overall, the mean age was 77±3 years, with 38.5% of patients being female. Age (78.0±8.2 vs. 76.9±9.6; P=0.74), body-mass-index (25.7±5.0 vs. 26.2±4.2; P=0.24), and the need for chronic renal replacement therapy (3% vs. 5%; P=0.99) showed no significant differences between females and males. Women had a greater prevalence of impaired left ventricular ejection fraction (LVEF <50%) compared to men (68% in females vs. 37% in males, P<0.001). Additionally, women underwent TAVI with smaller valve sizes (23 mm: 24%, 25 mm: 35%, 27 mm: 41%) in contrast to men (23 mm: 3%, 25 mm: 15%, 27 mm: 81%; P<0.001). Outcomes did not differ in terms of vascular complications (Figure 1A), bleeding complications (Figure 1B), and need for permanent pacemaker implantations (females: 19% vs. males: 20%; P=0.87). The overall mean transvalvular aortic pressure gradient at discharge was 4.5 ± 1.9 mmHg, showing no significant difference between females (4.2 ± 1.8 mmHg) and males (4.7 ± 1.9 mmHg; P=0.37). Paravalvular regurgitation was classified as mild in 7% of patients, while the other patients showing none or trace, with no significant differences between both groups (Figure 1C). Notably, one woman experienced a stroke (3%), while no man had a stroke. Additionally, two male patients died during the hospital stay.
Conclusion: In this multicenter study, women had a higher prevalence of impaired LVEF at the time of TAVI treatment. Both genders exhibited similar rates of in-hospital outcomes at discharge.
Figure 1. Outcomes in males vs females according to Valve Academic Research Consortium-3 criteria.