Related Experiment Video
Updated: May 3, 2026
12:17
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
11.3K
Gender-Tailored Heart Team Decision Making Equalizes Outcomes for Female Patients after Aortic Valve Replacement
Isabel Lavanchy1, Laina Passos2, Thierry Aymard1
1Department of Cardiac Surgery and Cardiology, Heart Clinic, Hirslanden Hospital, Witellikerstrasse 40, 8032 Zurich, Switzerland.
Journal of Cardiovascular Development and Disease
|October 25, 2024
Summary
This study found that despite women being older and having higher risk scores, mid-term outcomes after aortic valve replacement (AVR) via right anterior thoracotomy (RAST) were comparable between genders. RAST and heart team decision-making contribute to gender-tailored medicine.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Minimally Invasive Cardiac Surgery
Background:
- Gender-specific outcomes after aortic valve replacement (AVR) using the right anterior thoracotomy (RAST) approach are not well-established.
- This study aimed to evaluate mid-term outcomes in a cohort undergoing RAST for AVR, with a focus on gender differences.
Purpose of the Study:
- To analyze and compare mid-term outcomes of aortic valve replacement (AVR) performed via right anterior thoracotomy (RAST) between male and female patients.
- To investigate the influence of gender on outcomes within different age groups (≤60 and >60 years).
Main Methods:
- Retrospective analysis of 338 patients who underwent AVR via RAST between 2013 and 2022.
- Subgroup analysis comparing gender and age groups, including Euroscore II, operative times, postoperative stay, and complications.
- Mid-term follow-up was conducted on 315 patients (94.3%) to assess survival, MACCE, and re-intervention rates.
Main Results:
- Women were older (mean age 69.27 vs. 64.15 years) and had higher Euroscore II (1.25 vs. 0.94) compared to men (p < 0.001).
- Shorter bypass and cross-clamp times were observed in women (p = 0.01), but they experienced longer ICU and hospital stays (p = 0.005, p = 0.002) and higher rates of atrial fibrillation (6.7% vs. 4.4%, p = 0.024).
- Mid-term follow-up (4.52 years) revealed no significant differences in survival, MACCE, or re-intervention rates between genders or age groups.
Conclusions:
- Despite demographic and clinical differences, RAST for AVR resulted in comparable mid-term outcomes for both men and women.
- Patient-tailored heart team decision-making combined with the RAST approach appears to facilitate gender-tailored medicine, mitigating previously reported negative outcomes for female patients.
- The findings suggest that RAST is a safe and effective approach for AVR, offering equitable outcomes regardless of gender.
