Author + information
- Radhika Gadesam,
- Lakshmana Pendyala,
- Itsik Ben-Dor,
- Saar Minha,
- Rebecca Torguson,
- Joshua Loh,
- Omar Alfazir,
- Michael J. Lipinski,
- Wenjie Tian,
- Hideaki Ota and
- Ron Waksman
Balloon aortic valvuloplasty (BAV) is being used more and more as a bridging procedure to more definitive surgery or TAVR. The present study aims at evaluating the gender differences in clinical characteristics and outcomes of patients undergoing BAV in TAVR era.
From April 2009 to August 2012, the data from 331 BAV procedures done on patients with severe symptomatic AS were prospectively entered into a dedicated database. Clinical, hemodynamic, procedure and outcome data were collected. All events were defined according to Valve Academic Research Consortium [VARC] criteria.
The study cohort included 331 patients with mean age 82.5±10.2 years and mean aortic valve area 0.61±0.20. Men constitute 46% of the study population. Prior history of coronary artery disease (CAD), prior CABG, and lower EF [25-40%] were higher in men compared to women at presentation. On the other hand women had higher Society of Thoracic Surgeons (STS) score (p=0.006). There were no significant differences in the procedural characteristics except for significantly smaller balloon size (p<0.001) in women compared to men. Procedure complications similar both groups (overall 7%). All cause mortality 30 day and 1 year [28.5% vs. 34.2%, p=0.3] similar in both groups.
Women have higher STS score and men have higher CAD burden at presentation though the procedure outcomes, in hospital complications and one year all cause mortality after BAV have been similar.
|Pre BAV LV EF%||40.7±16.8||49.4±15.2||<0.001|
|Max. balloon diameter, mm||24.4±1.35||21.9±2.1||<0.001|
|Mean AV gradient change post BAV, mmHg||21.38±11.40||26.38±14.65||0.01|
|In hospital stroke||1.5%||1.3%||1.00|
|VARC minor bleed||3.1%||0||0.04|
|VARC stage 3 AKI||3.3%||0||0.05|
|In hospital Death||5.6%||5.3%||0.90|
|30 day mortality||5.9%||10.6%||0.13|
|One year mortality||34.2%||28.5%||0.3|