Sex-Specific Considerations in Degenerative Aortic Stenosis for Female-Tailored Transfemoral Aortic Valve Implantation Management

Masiero, Giulia; Paradies, Valeria; Franzone, Anna; Bellini, Barbara; De Biase, Chiara; Karam, Nicole; Sanguineti, Francesca; Mamas, Mamas A.; Eltchaninoff, Hélène; Fraccaro, Chiara; Castiglioni, Battistina; Attisano, Tiziana; Esposito, Giovanni; Chieffo, Alaide

Abstract

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.

Citation

Masiero, G., Paradies, V., Franzone, A., Bellini, B., De Biase, C., Karam, N., …Chieffo, A. (2022). Sex-Specific Considerations in Degenerative Aortic Stenosis for Female-Tailored Transfemoral Aortic Valve Implantation Management. Journal of the American Heart Association, 11(19), 1-15. https://doi.org/10.1161/jaha.121.025944

• Journal Article Type: Article
• Acceptance Date: Jun 28, 2022
• Online Publication Date: Sep 29, 2022
• Publication Date: Oct 4, 2022
• Publicly Available Date: May 30, 2023
• Journal: Journal of the American Heart Association
• Publisher: Wiley Open Access
• Peer Reviewed: Peer Reviewed
• Volume: 11
• Issue: 19
• Article Number: e025944
• Pages: 1-15
• DOI: https://doi.org/10.1161/jaha.121.025944
• Public URL: https://keele-repository.worktribe.com/output/424437
• Publisher URL: https://www.ahajournals.org/doi/10.1161/JAHA.121.025944