Comparison of Outcomes and Complications of Transcatheter Aortic Valve Implantation in Women Versus Men (from the National Inpatient Sample)

Transcatheter aortic valve implantation (TAVI) is a rapidly emerging procedure for the treatment of intermediate and high-surgical-risk patients with severe aortic stenosis. The impact of gender on in-hospital outcomes has not been studied on a large scale. The aim of this study was to examine gender differences in in-hospital outcomes after TAVI. The National Inpatient Sample (2012 to 2014) using the International Classification of Diseases, 9th Revision, Clinical Modification procedure codes for TAVI (35.05 and 35.06) were used to form this database. Propensity score matching (1:1) was performed and in-hospital outcomes were compared. The primary outcome was in-hospital mortality. Statistical analysis was performed using SAS 9.4 (SAS Institute Inc., Cary, North Carolina). A total of 41,050 (weighted) patients were included in our study. Women accounted for 47.7% (n = 19,570) in our study and presented with older age (81.7 years vs 80.5 years, p ≤ 0.0001). The population was predominantly white (87.4%). After performing propensity score-matched analysis (1:1), no difference in the primary outcome was noted between men and women. The secondary outcomes including stroke, hemorrhage requiring transfusion, and pericardial complications were higher in women. The composite end point of death and stroke occurred more frequently in women than in men. Acute renal failure was higher in men. The post-TAVI length of stay was higher in women (8.3 days vs 7.7 days, p = 0.0007). In conclusion, this large, retrospective registry analysis of patients with severe aortic stenosis who underwent TAVI suggests women may experience higher rates of in-hospital morbidity compared with men.