Abstract 14815: Sex Differences in Transcatheter Aortic Valve Replacement Outcomes Among Patients With Bicuspid Aortic Stenosis: Insights From the National In-Patient Sample

Introduction: Studies have shown higher in-hospital mortality and complications among women who underwent transcatheter aortic valve replacement (TAVR) compared to men. However, most of these studies excluded patients with bicuspid aortic stenosis (BAS). Our aim is to determine if there are sex differences in outcomes among patients with bicuspid AS who underwent TAVR.

Methods: This analysis was performed using the National Inpatient Sample (NIS) database. Multivariable regression analyses were performed to adjust for anticipated confounders for in-hospital outcomes. The main multivariable model (model A) included variables on patient demographics and comorbidities. Model B further adjusted for history of myocardial infarction (MI), prior percutaneous coronary intervention (PCI), and prior coronary artery bypass grafting (CABG). The main outcome is in-hospital mortality. ( See figure 1B)

Results: More TAVR were performed in men (61.1%) than women (38.9%). Men were more likely to have coronary artery disease, carotid artery disease, and peripheral vascular disease. (See table 1) There was no difference in in-hospital mortality between sexes (1.5 versus 2.4, adjusted odds ratio (aOR) 1.521, 95% confidence interval (CI) 0.523 - 4.424; p< 0.44. Furthermore, there was no sex difference in secondary outcomes.

Conclusions: A significantly higher proportion of men undergo the procedure as compared to women. There was no sex difference in in-hospital mortality and other secondary outcomes. More research is needed to address this sex gap in the performance of TAVR in BAS.