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Longitudinal Outcomes of Women Undergoing Transcatheter Aortic Valve Replacement.
- Source :
-
Innovations (Philadelphia, Pa.) [Innovations (Phila)] 2019 Aug; Vol. 14 (4), pp. 311-320. Date of Electronic Publication: 2019 May 15. - Publication Year :
- 2019
-
Abstract
- Objective: Recent data have suggested that women have a survival benefit at 1-year follow-up. However, long-term gender-based TAVR outcomes are lacking.<br />Methods: All patients undergoing isolated TAVR from 2011 to 2017 were included. Patients were stratified by gender. The primary outcomes of the study were 3-year mortality and 3-year hospital readmissions. Multivariable logistic regression analysis was used to evaluate the risk-adjusted impact of gender on TAVR outcomes.<br />Results: A total of 1,036 patients were divided into male ( n = 518) and female ( n = 518) cohorts. Women had a borderline significantly increased STS PROM (8.3% ± 5 vs. 7.7% ± 4.4; P = 0.05). The majority of procedures were performed under conscious sedation (male: 89% vs. female: 88%; P = 0.62) and via transfemoral access (male: 81.8% vs. female: 81.4%; P = 0.46). There was no difference in operative (30-day) mortality (male: 15 [3.3%] vs. female: 17 [3.7%]; P = 0.77) or 30-day readmissions (male: 40 [10.8%] vs. female: 44 [12.2%]; P = 0.56). Perioperative blood product usage was higher for women (male: 8.1% vs. female: 14.1%; P = 0.002). There was no significant difference in major vascular complications (male: 0.4% vs. female: 1.0%; P = 0.26) or major bleeding (male: 0.2% vs. female: 0.4%; P = 0.56). Permanent pacemaker placement was higher for males (11.6% vs. 7.0%; P = 0.01). On risk-adjusted multivariable analysis, gender was not a factor associated with mortality (HR 0.99 [0.76 to 1.30]; P = 0.99) or readmission (HR 0.90 [0.72 to 1.14]; P = 0.42) at 5 years.<br />Conclusions: There was no difference in survival or readmissions on multivariable analysis for women undergoing TAVR at 3 years. Longitudinal multi-institutional data will be important to validate these findings.
- Subjects :
- Aged
Aged, 80 and over
Blood Transfusion statistics & numerical data
Cardiac Pacing, Artificial statistics & numerical data
Female
Humans
Logistic Models
Longitudinal Studies
Male
Multivariate Analysis
Postoperative Complications epidemiology
Sex Factors
Aortic Valve Stenosis surgery
Mortality
Patient Readmission statistics & numerical data
Transcatheter Aortic Valve Replacement
Subjects
Details
- Language :
- English
- ISSN :
- 1559-0879
- Volume :
- 14
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Innovations (Philadelphia, Pa.)
- Publication Type :
- Academic Journal
- Accession number :
- 31088318
- Full Text :
- https://doi.org/10.1177/1556984519842943