부산대학교 도서관

Introduction: The incidence of aortic stenosis (AS) is increasing. If left untreated, AS progresses to clinical heart failure, reduced quality of life and functional capacity, and ultimately death.Hypothesis: Gender difference in survival benefits of transcatheter aortic valve implantation (TAVI) and frequencies of procedural complications.Methods: We included 600 consecutive, less selected, patients with symptomatic AS who underwent TAVI at our hospital. Clinical and echocardiographic data was analysed in SPSS. Data distribution was checked for normality. The inter-group comparison by Student’s t-test or chi square as appropriate. The association between gender and all-cause mortality assessed by Kaplan-Meier survival analysis with Log-rank test.Results: Mean age was 80.8±6.5 years of the study population. Women (49.3%) were older (82.2 ±5.3 years vs 79.5±7.3 years, p<0.001), had more severe AS and higher left ventricular ejection fraction and more often had basal septal hypertrophy. The prevalence of hypertension and use of antihypertensive medications were higher in women. The prevalence of diabetes mellitus, coronary artery disease, previous stroke, overall abnormal ECG, and atrial fibrillation was higher in men. The severity of symptoms, and prevalence of chronic kidney or lung diseases were comparable. The frequencies of procedure-related paravalvular leakage (PVL) ≥ grade II and endocarditis during follow-up were low, but significantly higher in men than women. No significant difference between genders in procedure-related access site dissection and pseudo-aneurysm, anaemia requiring blood transfusion, or new-onset renal failure. Need of permanent pacemaker implantation following TAVI was also comparable between genders. Mean event-free survival was 59±24 months for men and 66±25 months for women (p<0.001). Most apparent benefits was seen at 3-year follow-up where survival estimate for men was 84% and for women 92%.Conclusions: Results from TAVI-NOR study demonstrates that women with AS were older and had a higher burden of hypertensive heart disease, and showed a significantly better outcome. Men more frequently developed a significant PVL or endocarditis during follow-up.