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Masiero et al. Mini-invasive Surg 2022;6:4 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2021.104

Review Open Access

TAVI specific sex consideration

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Giulia Masiero , Valeria Paradies , Anna Franzone , Barbara Bellini , Chiara De Biase , Nicole Karam ,
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Francesca Sanguineti , Hélène Eltchaninoff , Chiara Fraccaro , Alaide Chieffo 4
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Department of Cardiac, Thoracic, Vascular Science and Public Health, University of Padova, Padova 35128, Italy.
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Department of Cardiology, Maasstad Hospital, Rotterdam 3079, Netherlands.
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Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples 80125, Italy.
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Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan 20132, Italy;
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Groupe CardioVasculaire Interventionnel, Clinique Pasteur, Toulouse 31076, France;
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Cardiology Department, European Hospital Georges Pompidou, Paris 75015, France;
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Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques CARTIER, Massy 91300, France;
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Normandie University, UNIROUEN, U1096, CHU Rouen, Department of Cardiology, Rouen F-76000, France.
Correspondence to: Prof. Alaide Chieffo, Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, 60, Via
Olgettina, Milan 20132, Italy. E-mail: chieffo.alaide@hsr.it
How to cite this article: Masiero G, Paradies V, Franzone A, Bellini B, De Biase C, Karam N, Sanguineti F, Eltchaninoff H, Fraccaro
C, Chieffo A. TAVI specific sex consideration. Mini-invasive Surg 2022;6:4. https://dx.doi.org/10.20517/2574-1225.2021.104
Received: 31 Aug 2021 First Decision: 26 Nov 2021 Revised: 5 Dec 2021 Accepted: 14 Dec 2021 Published: 6 Jan 2022
Academic Editor: Andrea Scotti Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen
Abstract
The impact of sex on baseline characteristics and morphological and clinical presentation of degenerative aortic
stenosis has been widely demonstrated but poorly understood. Moreover, differently from valve surgery, where
patients were predominantly male, both sexes have been well represented in percutaneous treatment of aortic
stenosis (AS), and women appeared to derive greater benefit with transfemoral aortic valve implantation (TAVI)
compared to surgical treatment. This review focuses on sex-specific differences in epidemiology, pathophysiology,
diagnostic issues, treatment options, and clinical outcomes of degenerative AS. Moreover, we evaluate how sex-
based TAVI management, from device selection to procedural tricks, may affect outcomes.

Keywords: Transcatheter aortic valve implantation, aortic stenosis, sex-specific differences, device selection,
clinical management

INTRODUCTION
Although sex differences in coronary artery disease have been well appreciated, the impact of sex on
valvular heart disease (VHD) has not been extensively discussed. Degenerative aortic stenosis (AS) currently

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
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