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Background: Sex-based differences in mortality have been previously observed in patients with surgically treated infective endocarditis. We sought to evaluate the risk factors leading to this difference. Methods: A retrospective cohort from three centers in Israel comprising 376 surgically treated patients, comparing short- and long-term mortality rates and risk factors between female and male patients. Results: Compared to male patients, female patients had higher rates of hypertension (62% vs. 48%), higher rates of Gram-negative infections (20% vs. 11%), and more mitral valve replacement (55% vs. 42%). Diabetes and age were the most significant predictors for mortality and did not differ between female and male patients. In-hospital mortality rates did not differ between female and male patients (29% vs. 26%), and the difference in long-term mortality was not statistically significant (46% vs. 36% p = 0.088). Conclusions: No statistical difference was observed in short- and long-term mortality between female and male patients, most likely due to a lack of difference in the rates of important risk factors such as diabetes and age. Mortality rates decreased in the last 10 years, and a good prognosis is observed for patients surviving the initial 30 days after surgery. [ABSTRACT FROM AUTHOR]

There are few reports on short-term changes in renal function after surgical aortic valve replacement, and data are scarce regarding its impact on long-term outcomes. This is a retrospective study of patients who underwent isolated aortic valve replacement between 2009 and 2020 in four medical centers. Patients with end-stage renal disease were excluded. Renal function was assessed based on short-term changes. Multivariable regression models were used to identify predictors of improvement/deterioration. Cox proportional hazard models were used to assess survival trends. The study included 2402 patients, with a mean age of 69.3 years and a mean eGFR of 82.3 mL/min/1.73 m2. Short-term improvement rates were highest in stage 4 (24.4%) and stage 3 (16.8%) patients. Deterioration rates were highest in stage 1 (38.1%) and stage 2 (34.8%) patients. Deterioration in the chronic kidney disease stage was associated with a higher ten-year mortality (p < 0.001, HR 1.46); an improved stage trended toward improved survival (p = 0.14, HR 0.722). Patients with stage 3 and 4 kidney disease tended to remain stable or improve in the short term after aortic valve replacement while patients at stages 1 and 2 were at increased risk of deteriorating. [ABSTRACT FROM AUTHOR]

Background: Patients with low-gradient (LG) severe aortic stenosis (AS) have worse outcome following surgical aortic valve replacement (SAVR) than patients with high-gradient AS. We hypothesized that transcatheter aortic valve replacement (TAVR) may be a better treatment option for these patients. The aim of this study was to compare outcomes of patients with LG AS referred for TAVR and SAVR.Methods: We analysed clinical, echocardiographic and outcome data in 50 consecutive patients (age 81 ± 6 years, 50% females) with LG AS (aortic valve area ≤ 1 cm2, mean aortic valve pressure gradient <40 mmHg and peak aortic jet velocity < 4 m/s) who underwent TAVR, and compared them with 80 patients (age 76 ± 7 years, 35% females) who underwent SAVR.Results: Over 4 years of follow-up there was no difference in survival free of stroke, long-term dialysis or urgent rehospitalization and overall survival between patients undergoing TAVR or SAVR (12% and 61% vs. 19% and 67%, p = 0.9 and 0.8, respectively), even though TAVR patients were significantly older, had more comorbidities and had a higher EuroSCORE II. After adjustment for these covariates, TAVR was associated with better event-free survival (adjusted HR: 0.63, 95% CI 0.40-0.97, p = 0.044).Conclusion: Patients with LG AS had better adjusted event-free survival when referred to TAVR rather than to SAVR.Summary: Symptomatic patients with low-gradient severe aortic stenosis are at high risk for surgical aortic valve replacement. In this study, Transcatheter, as compared to surgical aortic valve replacement, was associated with better adjusted event free survival in patients with low gradient aortic stenosis. [ABSTRACT FROM AUTHOR]