title: Gender differences in clinical presentation and surgical outcome of aortic stenosis.
abstract: BACKGROUND
  Little is known about the gender differences of patients undergoing aortic valve replacement (AVR) for isolated severe aortic stenosis.
  
  
  RESULTS
  408 consecutive patients (215 women and 193 men; p=0.9) were analysed. At presentation, women were older (73.7+/-9.3 years vs men 66.5+/-11.5 years; p<0.001), more symptomatic (New York Heart Association (NYHA) class: women 2.3+/-0.7 vs men 2.0+/-0.65; p<0.001), and presented with smaller valve areas (women 0.6+/-0.2 cm(2) vs men 0.7+/-0.2 cm(2); p<0.001) and higher mean pressure gradients (women 67.3+/-19.2 mm Hg vs men 62.2+/-20.0 mm Hg, p=0.001). Despite older age and more advanced disease in women, operative mortality did not differ. Survival after AVR by Kaplan-Meier analysis tended to be even better in women (92.8%, 89.8%, 81.4% vs men 89.1%, 86.6%, 76.3% at 1, 2 and 5 years, p=0.31). After division into age quintiles, the outcome of women was significantly better in patients older than 79 years (p=0.005). After adjustment for clinical characteristics, gender did not predict operative mortality and late outcome. Despite physical improvement in both groups after surgery, women remained more symptomatic (NYHA class: women 1.6+/-0.7 vs men 1.3+/-0.4; p=0.001).
  
  
  CONCLUSIONS
  Although women referred to AVR are older and more symptomatic, operative and long-term mortality are not increased. In the oldest age group of 79 years and older, women even have a better outcome, presumably due to a longer mean life expectancy.
authors.affiliation: Department of Cardiology, Medical University of Vienna, University Hospital, Waehringer Guertel 18-20, A-1090 Vienna, Austria. julia.mascherbauer@meduniwien.ac.at
authors.forename: Christina
authors.initials: C
authors.lastname: Fuchs
authors.forename: Julia
authors.initials: J
authors.lastname: Mascherbauer
authors.forename: Raphael
authors.initials: R
authors.lastname: Rosenhek
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Pernicka
authors.forename: Ursula
authors.initials: U
authors.lastname: Klaar
authors.forename: Christine
authors.initials: C
authors.lastname: Scholten
authors.forename: Maria
authors.initials: M
authors.lastname: Heger
authors.forename: Gregor
authors.initials: G
authors.lastname: Wollenek
authors.forename: Martin
authors.initials: M
authors.lastname: Czerny
authors.forename: Gerald
authors.initials: G
authors.lastname: Maurer
authors.forename: Helmut
authors.initials: H
authors.lastname: Baumgartner
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017023:Coronary Angiography; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011300:Preoperative Care; D012737:Sex Factors; D016896:Treatment Outcome