1. Sex-Related Differences in Outcomes After Percutaneous Balloon Aortic Valvuloplasty.
- Author
-
Daniec M, Dziewierz A, Sorysz D, Kleczyński P, Rakowski T, Rzeszutko Ł, Trębacz J, Tomala M, Nawrotek B, Żmudka K, and Dudek D
- Subjects
- Aged, Aged, 80 and over, Aortic Valve Stenosis diagnosis, Aortic Valve Stenosis mortality, Balloon Valvuloplasty adverse effects, Cardiac Catheterization adverse effects, Female, Hospital Mortality trends, Humans, Male, Poland epidemiology, Retrospective Studies, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome, Aortic Valve surgery, Aortic Valve Stenosis surgery, Balloon Valvuloplasty methods, Cardiac Catheterization methods, Heart Valve Prosthesis, Postoperative Complications epidemiology, Transcatheter Aortic Valve Replacement methods
- Abstract
Objectives: We aimed to evaluate sex-related differences in short-term and long-term outcomes of patients undergoing balloon aortic valvuloplasty (BAV) for severe aortic stenosis (AS)., Methods: A total of 112 patients with severe AS underwent 114 BAV procedures as palliative procedure, bridge to definitive treatment, or before urgent non-cardiac surgery. Patients were followed for 24 months., Results: Of the 112 patients, 70 (62.5%) were women. Women were older, and had a higher STS score and higher prevalence of chronic kidney disease and arterial hypertension. Indications for BAV did not differ by gender. Women had a higher risk of vascular complications than men (15.7% vs 0.0%; P=.01), but with a similar rate of major periprocedural complications (17.1% vs 9.5%; P=.40). Transcatheter aortic valve implantation (TAVI) was performed in 22.8% of women and 26.2% of men (P=.61) and surgical aortic valve replacement in 10% of women and 11.9% of men (P=.70). Women and men treated finally with TAVI/aortic valve replacement had lower mortality as compared with conservative treatment (P<.01). No difference in in-hospital and 24-month mortality between women and men was observed (11.4% vs 4.9% [P=.26]; 63.3% vs 39.0% [P=.22], respectively). In a multivariable Cox model, STS score above 9.8% (hazard ratio, 2.29; 95% confidence interval, 1.09-4.83; P=.03) was an independent predictor of all-cause death only in women., Conclusion: Despite the presence of sex-related differences in baseline and procedural characteristics as well as in the risk of vascular complications, no difference in major procedural complications and long-term mortality was confirmed for patients with severe AS undergoing BAV.
- Published
- 2017