Masiero Giulia, Franzone Anna, Paradies Valeria, Karam Nicole, Fraccaro Chiara, De Biase Chiara, Alasnag Mirvat, Botti Giulia, Cascone Angelicarosa, Cid-Alvarez Ana Belen, Rudolph Tanja K, Kaluzna-Oleksy Marta, Manzo-Silberman Stephane, Mehilli Julinda, Stähli Barbara E, Grapsa Julia, Panaou Kyriakos, Bellini Barbara, Wykrzykowska Joanna J, Bleiziffer Sabine, Eltchaninoff Helene, Gilard Martine, Chieffo Alaide
Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua Medical School, Padua, Italy.
Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
Struct Heart. 2025 May 30;9(7):100666. doi: 10.1016/j.shj.2025.100666. eCollection 2025 Jul.
The impact of sex on the baseline characteristics, morphology, and clinical presentation of degenerative aortic stenosis (AS) is well-documented but remains poorly understood. Unlike valve surgery, for which patients have been predominantly male, percutaneous treatment of AS has shown balanced representation of both sexes, with women demonstrating greater benefit from transfemoral aortic valve replacement compared to surgical treatment. This review explores sex-specific differences in the epidemiology, pathophysiology, diagnostic challenges, treatment approaches, and clinical outcomes of degenerative AS. Furthermore, it addresses technical, sex-specific considerations in transfemoral aortic valve replacement, including preprocedural screening, device selection, implantation strategy, and postprocedural management.
性别对退行性主动脉瓣狭窄(AS)的基线特征、形态学及临床表现的影响已有充分记录,但仍了解不足。与主要为男性患者接受的瓣膜手术不同,AS的经皮治疗显示男女比例均衡,与手术治疗相比,女性从经股动脉主动脉瓣置换术中获益更大。本综述探讨了退行性AS在流行病学、病理生理学、诊断挑战、治疗方法及临床结局方面的性别差异。此外,还讨论了经股动脉主动脉瓣置换术中针对性别的技术考量,包括术前筛查、器械选择、植入策略及术后管理。