title: Risk and Outcome of Aortic Valve Surgery in the Transcatheter Valve Era: The Gender Aspect.
abstract: OBJECTIVE
  In 2009, a transcatheter valve intervention program was introduced at our centre. The aim of this single-centre retrospective study was to evaluate gender-specific risk profiles and outcome of patients undergoing surgical aortic valve replacement before and after 2009.
  
  
  METHODS
  We assessed the preoperative logistic EuroSCORE and age, gender and 30-day-survival of 357 patients diagnosed with symptomatic severe aortic stenosis that underwent primary isolated surgical aortic valve replacement in 2007-2008 (group I, n = 191, 47% female) and 2010-2011 (group II, n = 166, 40% female). Survival follow up data was 100% complete.
  
  
  RESULTS
  Women in group II were significantly younger (71.6 ± 9.0 years; p = 0.004) and showed significantly lower risk profiles (logistic EuroSCORE: 9.6 ± 9.9%; p = 0.04) than women in group I (age: 75.6 ± 8.5 years, logistic EuroSCORE: 13.9 ± 15.9). Men's age and risk profiles remained similar in both groups. Observed survival at 30 days was 98.8% in group II and 95.8% in group I which represented a statistical trend (p = 0.09). Female survival in group I was 92.2% and significantly worse as compared to 99% male survival in group I (p = 0.03). This significant difference in gender ratio of mortality was not detected in group II (female survival 97%, male survival 100%; p = 0.2). Being female was a significant risk factor in group I (odds ratio; 8.4; p = 0.03) but not in group II any longer (odds ratio: 1.0; p = 0.2).
  
  
  CONCLUSIONS
  The possibility of transcatheter aortic valve replacement for therapy of aortic stenosis has led to a lower risk and improved outcome of surgical aortic valve replacement especially for women.
authors.affiliation: Department of Cardiovascular Surgery, Charité Hospital, Medical University, Berlin, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Heinze
authors.forename: Torsten
authors.initials: T
authors.lastname: Christ
authors.forename: Christopher O
authors.initials: CO
authors.lastname: Leonards
authors.forename: Pascal M
authors.initials: PM
authors.lastname: Dohmen
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Konertz
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate; D065467:Transcatheter Aortic Valve Replacement; D016896:Treatment Outcome