[Influence of sex on perioperative outcomes in patients undergoing valve replacement for severe aortic stenosis].
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.
Caballero-Borrego
Juan
J
Area del Corazón, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain. jcabbor1@hotmail.com
Gómez-Doblas
Juan J
JJ
Valencia-Serrano
Félix M
FM
Cabrera-Bueno
Fernando
F
Rodríguez-Bailón
Isabel
I
Sánchez-Espín
Gema
G
Such
Miguel
M
Orrit
Javier
J
Porras
Carlos
C
Melero
José M
JM
Olalla-Mercadé
Eduardo
E
de Teresa-Galván
Eduardo
E
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