Structural Heart Interventions in Women with Congenital Heart Disease

To provide a review of current transcatheter interventions in women with congenital heart disease, with a focus on sex-specific considerations in diagnosis, management, and follow-up.

As the field of pediatric cardiology advances and patients with previously life-limiting diagnoses now survive well into adulthood, there is a growing need to pursue management strategies that improve quality of life. Unfortunately, in the treatment of cardiovascular disease, women have historically been underrepresented in research studies and clinical trials, which may limit the generalizability of available evidence and contribute to disparities in outcomes. Women with congenital heart disease (CHD) are an even more vulnerable population given the relatively low prevalence of CHD. This review discusses several CHD lesions and current trends in diagnosis, management, and follow-up in women. Additionally, it highlights sex-specific considerations in this unique patient population. Future initiatives and applications that may help improve the lifetime care of women with CHD are also reviewed. Although there have been increasing efforts to improve the inclusion of women in medical research in recent years, substantial gaps in representation remain. As emerging technologies are increasingly introduced in the CHD field, there is an important opportunity to improve the representation of women in studies evaluating procedural outcomes. Tools such as artificial intelligence and machine learning may help facilitate scalable screening and risk-stratification strategies for women with CHD.