title: [Influence of sex on perioperative outcomes in patients undergoing valve replacement for severe aortic stenosis].
abstract: OBJECTIVE
  The influence of sex on the prognosis of patients undergoing aortic valve replacement for severe stenosis is unclear. Nevertheless, a number of studies have regarded sex as an independent risk factor. The aim of this study was to evaluate the influence of sex on perioperative outcomes in patients undergoing valve replacement for severe aortic stenosis.
  
  
  METHODS
  This retrospective study involved 577 consecutive patients who underwent aortic valve replacement surgery for severe aortic stenosis between 1996 and April 2007.
  
  
  RESULTS
  Women (44% of patients) were older than men (70.3+/-7.9 years vs. 66.8+/-9.8 years; P< .001), had a smaller body surface area (1.68+/-0.15 m(2) vs. 1.83+/-0.16 m(2); P< .001), more often had arterial hypertension (73% vs. 49%; P< .001), diabetes mellitus (33.5% vs. 24.5%; P=.001) and ventricular hypertrophy (89.1% vs. 83.1%; P< .001), and less often had coronary artery disease (19.1% vs. 31.8%; P< .001) and severe ventricular dysfunction (7.9% vs. 17.4%; P< .001). Nevertheless, women more often suffered acute myocardial infarction perioperatively (3.9% vs. 0.9%; P=.016), had a low cardiac output in the postoperative period (30.3% vs. 22.3%; P=.016) and experienced greater perioperative mortality (13% vs. 7.4%; P=.019) than men. However, after adjustment for various confounding factors, female sex was not a significant independent risk factor for mortality (odds ratio = 2.40; 95% confidence interval, 0.79-7.26; P=.119).
  
  
  CONCLUSIONS
  Perioperative mortality in women with severe aortic stenosis who underwent valve replacement was high. However, after adjustment for potential confounding factors, particularly body surface area, female sex was not an independent risk factor for mortality.
authors.affiliation: Area del Corazón, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain. jcabbor1@hotmail.com
authors.forename: Juan
authors.initials: J
authors.lastname: Caballero-Borrego
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Gómez-Doblas
authors.forename: Félix M
authors.initials: FM
authors.lastname: Valencia-Serrano
authors.forename: Fernando
authors.initials: F
authors.lastname: Cabrera-Bueno
authors.forename: Isabel
authors.initials: I
authors.lastname: Rodríguez-Bailón
authors.forename: Gema
authors.initials: G
authors.lastname: Sánchez-Espín
authors.forename: Miguel
authors.initials: M
authors.lastname: Such
authors.forename: Javier
authors.initials: J
authors.lastname: Orrit
authors.forename: Carlos
authors.initials: C
authors.lastname: Porras
authors.forename: José M
authors.initials: JM
authors.lastname: Melero
authors.forename: Eduardo
authors.initials: E
authors.lastname: Olalla-Mercadé
authors.forename: Eduardo
authors.initials: E
authors.lastname: de Teresa-Galván
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome