Gender Differences in Clinical Outcomes Following Isolated Aortic Valve Replacement

Background
Aortic Valve Replacement (AVR) is a critical surgical procedure for treating patients with aortic valve diseases. Previous studies have indicated differences in morbidity and mortality outcomes between men and women undergoing AVR, potentially due to variations in the causes and progression of aortic diseases, as well as gender-related differences in surgical outcomes. However, data specifically comparing these outcomes in men and women undergoing isolated AVR remains limited.

Objectives
The aim of this study was to compare clinical outcomes, including mortality and post-operative complications, between men and women who underwent isolated AVR at Sheba Medical Center over a 20-year period.

Methods
This single-center, retrospective, observational case-control study included all patients who underwent isolated AVR from 2004 to 2024. We compared numerous variables between men and women, including all-cause mortality, in-hospital mortality, and post-operative complications. Statistical analyses were performed using Chi-squared or Fisher’s test for categorical variables and T-test for continuous variables.

Results
A total of 1,281 patients (806 men and 475 women) underwent isolated AVR during the study period. There were no significant differences in all-cause mortality (25.8% for men vs. 29.7% for women, p = 0.15) or in-hospital mortality (3.1% for men vs. 2.7% for women, p = 0.68). However, there was a significantly higher rate of sternum infections in the men’s group (4.2% vs. 1.9%, p = 0.002) and a higher rate of revisions in men (5.5% vs. 2%, p = 0.029). Other post-operative complications showed no statistically significant differences between the two groups.

Conclusions
Gender differences in AVR outcomes appear to be limited to certain post-operative complication. The findings highlight the need for tailored post-operative care to address gender-specific complications, while reinforcing that isolated AVR remains a successful intervention for both men and women in terms of survival.