Sex-Related Differences in Clinical Characteristics and Outcome of Patients Undergoing Transcatheter Aortic Valve Implantation- Data from the Israeli TAVI Registry

Osnat Itzhaki Department of Cardiology, Rabin Medical Center, Israel Sackler Faculty of Medicine, Tel Aviv University, Israel Katia Orvin Department of Cardiology, Rabin Medical Center, Israel Sackler Faculty of Medicine, Tel Aviv University, Israel Ariel Finkelstein Sackler Faculty of Medicine, Tel Aviv University, Israel Department of Cardiology, Sourasky Medical Center, Israel Israel M Barbash Sackler Faculty of Medicine, Tel Aviv University, Israel Department of Cardiology, Sheba Medical Center, Israel Haim Danenberg Department of Cardiology, Hadassah Medical Center, Israel Faculty of Medicine, Hebrew University of Jerusalem, Israel Amit Segev Sackler Faculty of Medicine, Tel Aviv University, Israel Department of Cardiology, Sheba Medical Center, Israel Victor Guetta Sackler Faculty of Medicine, Tel Aviv University, Israel Department of Cardiology, Sheba Medical Center, Israel Amir Halkin Sackler Faculty of Medicine, Tel Aviv University, Israel Department of Cardiology, Sourasky Medical Center, Israel David Planer Department of Cardiology, Hadassah Medical Center, Israel Faculty of Medicine, Hebrew University of Jerusalem, Israel Tamir Bental Department of Cardiology, Rabin Medical Center, Israel Sackler Faculty of Medicine, Tel Aviv University, Israel Hana Vaknin Assa Department of Cardiology, Rabin Medical Center, Israel Sackler Faculty of Medicine, Tel Aviv University, Israel Abid Assali Department of Cardiology, Rabin Medical Center, Israel Sackler Faculty of Medicine, Tel Aviv University, Israel Alon Barsheshet Department of Cardiology, Rabin Medical Center, Israel Sackler Faculty of Medicine, Tel Aviv University, Israel Ran Kornowski Department of Cardiology, Rabin Medical Center, Israel Sackler Faculty of Medicine, Tel Aviv University, Israel

Background: Cumulative findings from various worldwide cohorts have shown sex-related differences in patients undergoing transcatheter aortic valve implantation (TAVI), yet data regarding procedural and long-term outcome are conflicting.

Aims: To evaluate sex-related differences regarding demographic and echocardiographic characteristics, procedural outcome and complications and long-term outcomes in patients undergoing TAVI.

Method: We evaluated patients who underwent TAVI for severe symptomatic aortic stenosis from a large TAVI registry in 4 tertiary hospitals in Israel between the years 2008-2016.

Results: Our final cohort included 1,359 female and 1,136 male patients. Female patients compared to male patients were less likely to present with a history of coronary artery disease (39% versus 67%, p<0.001), had a more favorable STS (Society of Thoracic Surgeons) score (4.8±4 versus 5.0±3.3, p<0.001), but were more frequently defined as frail (30% versus 17%, respectively, p<0.001). Female patients had a smaller valve area with higher peak and mean gradients compared to male patients (p

Conclusion: Female patients undergoing TAVI present with distinct baseline and procedure-related characteristics which may impact procedure related complications and long term outcome. Improved prognosis was observed among women versus men in the early TAVI period but outcomes seem to balance in the current period.

Osnat Itzhaki