Division of Radiology, St Paul's Hospital, University of British Columbia, Vancouver, Canada.
Division of Cardiology, St Paul's Hospital, University of British Columbia, Vancouver, Canada.
JACC Cardiovasc Imaging. 2016 Apr;9(4):483-93. doi: 10.1016/j.jcmg.2016.02.009.
Transcatheter aortic valve replacement (TAVR) has become the standard of care for patients with hemodynamically severe aortic stenosis who are symptomatic but deemed too high risk for surgery. Recent reports suggest that sex differences exist in outcomes following TAVR and in the diagnostic imaging evaluation of patients being considered for TAVR. In this review, the authors explore the differences between men and women in baseline characteristics and outcomes following TAVR, as well as sex differences in the imaging findings of severe aortic stenosis (AS) including the diagnostic challenges in the hemodynamic assessment of severe AS in elderly women, differences in aortic valvular calcification and in the associated myocardial response to severe AS. Additionally, sex differences in imaging findings as they relate to post-TAVR complications including coronary obstruction, annular rupture and prosthesis-patient mismatch are also discussed.
经导管主动脉瓣置换术（TAVR）已成为有症状但因手术风险过高而被认为不适合手术的严重主动脉瓣狭窄患者的标准治疗方法。最近的报告表明，TAVR 后的结果以及考虑进行 TAVR 的患者的诊断影像学评估存在性别差异。在这篇综述中，作者探讨了 TAVR 后男性和女性在基线特征和结果方面的差异，以及严重主动脉瓣狭窄（AS）的影像学表现中的性别差异，包括老年女性严重 AS 血流动力学评估中的诊断挑战、主动脉瓣钙化的差异以及严重 AS 相关的心肌反应。此外，还讨论了与 TAVR 后并发症相关的影像学表现中的性别差异，包括冠状动脉阻塞、瓣环破裂和假体-患者不匹配。
