Abstract 42: Differences in Presentation, Process, and Outcomes of Aortic Valve Surgery for Women versus Men

BACKGROUND: There is a rich literature on differences in process and outcomes for women versus men undergoing coronary revascularization. Much less is known about gender differences for patients undergoing valve replacement surgery. HYPOTHESIS: Extrapolating from revascularization, women undergoing aortic valve replacement (AVR) for aortic stenosis would have greater severity of illness, more comorbidities and worse outcomes than men. METHODS: From our Northern New England Cardiac Surgery Registry we identified 4133 patients who underwent AVR for severe stenosis (area <1.0 cm2) between 1/1/2000-12/31/2010; 2144 isolated AVRs and 1969 AVR+CABG. We compared severity of illness, comorbidities, the process of care, and in-hospital outcomes for women versus men, stratifying by concomitant CABG, using standard statistical techniques. RESULTS: Women comprised 47.9% of AVRs and 36.4% of AVR+CABGs. In the AVR population women were older, smaller, had more symptoms of heart failure but had less renal and coronary disease. They had shorter pump runs despite being more likely to receive blood products. Outcomes were similar to those in men including mortality (3.5% v 2.2% women v men; adjusted OR 1.32, 95%CI 0.71-2.44). In the AVR+CABG population women were older, smaller, and had more hypertension but less vascular disease and multivessel coronary disease. Again, pump runs were shorter but the use of blood products was greater. Mortality was higher for women than men (7.5% women v 3.8% men; adjusted OR 2.12, 95%CI 1.32-3.43) with no difference in other outcomes. CONCLUSION: In-hospital outcomes for women undergoing isolated AVR are comparable to those in men. However, as with isolated CABG, AVR+CABG is associated with higher mortality for women than for men. Why this is true remains to be determined. ![Graphic][1] [1]: /embed/inline-graphic-1.gif