Impact of Sex on the Outcome of Isolated Aortic Valve Replacement and the Role of Different Preoperative Profiles.

OBJECTIVE

The aim of this study was to compare the patient profiles and outcomes of men and women undergoing isolated aortic valve replacement.

METHODS

Patient data were analyzed retrospectively.

METHODS

This single-center study was performed at Catharina Hospital in Eindhoven, the Netherlands.

METHODS

The study comprised 2,362 patients, of whom 1,040 (44%) were women and 1,322 were men (56%).

METHODS

Isolated aortic valve replacement was performed between January 1998 and December 2016.

RESULTS

The mean follow-up was 8.3 ± 5.1 years. Women were relatively older (69.9 years v 64.6 years; p < 0.001); more of them were underweight, obese, and diabetic; and they had lower hemoglobin values and worse renal function than did men. However, fewer women than men experienced chronic obstructive pulmonary disease, aortic regurgitation, left ventricular dysfunction, and endocarditis. Early mortality did not differ significantly between men and women (p = 0.238). Overall survival was worse in women (p < 0.001). After correction for potential risk factors, female sex was not associated with worse survival. During the study period, the mean age of patients undergoing aortic valve replacement increased. In addition, the mean age at the time of death increased, following the trend of national statistics.

CONCLUSIONS

Although women undergoing aortic valve replacement have relatively more risk factors than do men, early mortality in women is not significantly higher than in men. Overall survival is worse in women than in men; however, after adjustment for preoperative risk factors, there is no difference in overall survival between women and men.